Treatment of Myositis Associated With Immune Checkpoint Inhibitors
Current Treatment Options in Rheumatology - Trang 1-13 - 2023
Tóm tắt
To analyze and provide an update of the current therapeutic strategies on immune checkpoint inhibitor-related myositis, including forms with concurrent myocarditis and/or myasthenia. Moreover, we aim to assess the risk of rechallenging with ICI as well as the potential abrogation of antitumor immunity with the immunosuppressive therapy. Therapeutic recommendations indicate that the best initial approach in patients with myositis is withholding ICI therapy and initiating treatment with corticosteroids. In severe forms, the use of intravenous immunoglobulins, plasma exchange, or additional oral immunosuppressants should be considered. The benefit of new biological drugs has recently been pointed out, highlighting IL-6 receptor inhibitors and Janus kinase inhibitors. Corticosteroids are considered as the first-line therapy for patients with myositis. Intensive or rescue therapies may be useful in corticosteroid-refractory patients as well as in those with myasthenia or myocarditis. Prospective studies are needed to better understand the mechanism of myositis so that new targeted therapies could arise. Further research is key to improve the therapeutic options that lead to resolution of ICI-related adverse events while preserving antitumor effects.
Tài liệu tham khảo
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