Pembrolizumab-induced polymyalgia rheumatica in two patients with metastatic melanoma

Garel, B.; Kramkimel, N.; Trouvin, Anne-Priscille; Frantz, Camélia; Dupin, Nicolas

doi:10.1016/j.jbspin.2016.01.007

Cited by 28 publications

(7 citation statements)

References 7 publications

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“…In addition, a presumptive PR diagnosis linked with other immune checkpoint inhibitors supports our cause–effect association. In our patient, and others from existing literature reports, 1–3,6–8 symptom onset was after one to three treatment cycles and resolved shortly after administration of oral steroids.…”

Section: Discussionsupporting

confidence: 75%

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Polymyalgia rheumatica due to pembrolizumab therapy

Iskandar

Hwang

Dasanu

2018

J Oncol Pharm Pract

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Pembrolizumab is a humanized anti-programmed cell death 1 antibody used for the therapy of several malignancies. While autoimmune adverse events are not uncommon with this agent, they are typically mild and self-limiting. Severe autoimmunity is rare but can be life-threatening. Herein, we describe a unique case of severe proximal muscle weakness and joint pain shortly after beginning therapy with pembrolizumab. Work-up revealed elevated pro-inflammatory markers leading to the diagnosis of polymyalgia rheumatica. Steroids allowed for resolution of the joint pain. We call for awareness of this rare autoimmune toxicity with pembrolizumab.

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Section: Discussionsupporting

confidence: 75%

“…Garel et al. 3 described two patients with metastatic melanoma who experienced similar symptoms of myalgia and morning stiffness with pembrolizumab. The first patient had an onset of symptoms 24 h after the initial infusion, while the second patient experienced these symptoms after three pembrolizumab infusions.…”

Section: Discussionmentioning

confidence: 98%

Polymyalgia rheumatica due to pembrolizumab therapy

Iskandar

Hwang

Dasanu

2018

J Oncol Pharm Pract

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“…Indeed, two cases were previously described17 and we now report four additional cases. Interestingly, giant cell arteritis was recently found to involve a deficiency in the PD-1 immune checkpoint: vessel-wall dendritic cells fail to express PDL1, which leaves lesional T cells unchecked 18…”

Section: Discussionmentioning

confidence: 55%

Rheumatoid arthritis and polymyalgia rheumatica occurring after immune checkpoint inhibitor treatment

Belkhir¹,

Burel²,

Dunogeant³

et al. 2017

Ann Rheum Dis

218

128

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“…None of them had symptoms concerning for giant cell arteritis [ 10 ]. Other patients receiving nivolumab and pembrolizumab developed typical features of PMR that responded well to corticosteroid treatment [ 48 , 49 ].…”

Section: Resultsmentioning

confidence: 99%

Musculoskeletal and Rheumatic Diseases Induced by Immune Checkpoint Inhibitors: A Review of the Literature

Benfaremo

Manfredi

Luchetti

et al. 2018

CDS

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Background: Immune checkpoint inhibitors are a new promising class of antitumor drugs that have been associated with a number of immune-related Adverse Events (AEs), including musculoskeletal and rheumatic disease.Methods: We searched Medline reviewing reports of musculoskeletal and rheumatic AEs induced by immune checkpoint inhibitors.Results: Several musculoskeletal and rheumatic AEs associated with immune checkpoint inhibitors treatment are reported in the literature. In particular, arthralgia and myalgia were the most common reported AEs, whereas the prevalence of arthritis, myositis and vasculitis is less characterized and mainly reported in case series and case reports. Other occasionally described AEs are sicca syndrome, polymyalgia rheumatica, systemic lupus erythematosus and sarcoidosis.Conclusion: Newly induced musculoskeletal and rheumatic diseases are a frequent adverse event associated with immune checkpoint inhibitors treatment

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Pembrolizumab-induced polymyalgia rheumatica in two patients with metastatic melanoma

Cited by 28 publications

References 7 publications

Polymyalgia rheumatica due to pembrolizumab therapy

Polymyalgia rheumatica due to pembrolizumab therapy

Rheumatoid arthritis and polymyalgia rheumatica occurring after immune checkpoint inhibitor treatment

Musculoskeletal and Rheumatic Diseases Induced by Immune Checkpoint Inhibitors: A Review of the Literature

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