The management of rheumatic immune related adverse events.

IF 4.8 2区 医学 Q1 RHEUMATOLOGY
Pankti Reid, Namrata Singh, Tawnie Braaten, Laura C Cappelli
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引用次数: 0

Abstract

Immune checkpoint inhibitors (ICI) used for the treatment of cancer can cause immune related adverse events (irAEs) when immune activation affects non-tumor tissues. Rheumatologists care for patients with a variety of rheumatic irAEs; these included inflammatory arthritis (ICI-IA), polymyalgia rheumatica (ICI-PMR), and myositis (ICI-myositis) among others. Rheumatic irAEs are commonly impactful on patients' quality of life and function and sometimes can cause significant morbidity and mortality. This review will highlight the diagnosis and assessment of rheumatic irAEs. Then treatment for individual irAEs will be discussed in depth with considerations to supportive care, corticosteroid dosing and tapering, steroid sparing immunosuppression and monitoring. Finally, the safety of immunosuppression as it relates to tumor outcomes and considerations by oncologists when selecting ICI therapy will be reviewed.

风湿病免疫相关不良事件的处理。
当免疫激活影响非肿瘤组织时,用于治疗癌症的免疫检查点抑制剂(ICI)可引起免疫相关不良事件(irAEs)。风湿病学家照顾患有各种风湿性关节炎的患者;这些包括炎症性关节炎(ICI-IA)、风湿性多肌痛(ICI-PMR)和肌炎(ici -肌炎)等。风湿性irAEs通常会影响患者的生活质量和功能,有时会导致显著的发病率和死亡率。本文将重点介绍风湿病irAEs的诊断和评估。然后将深入讨论个体irAEs的治疗,包括支持性护理、皮质类固醇剂量和减量、类固醇保留免疫抑制和监测。最后,将回顾免疫抑制的安全性,因为它与肿瘤预后有关,肿瘤学家在选择ICI治疗时应考虑到这一点。
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来源期刊
CiteScore
9.40
自引率
0.00%
发文量
43
审稿时长
27 days
期刊介绍: Evidence-based updates of best clinical practice across the spectrum of musculoskeletal conditions. Best Practice & Research: Clinical Rheumatology keeps the clinician or trainee informed of the latest developments and current recommended practice in the rapidly advancing fields of musculoskeletal conditions and science. The series provides a continuous update of current clinical practice. It is a topical serial publication that covers the spectrum of musculoskeletal conditions in a 4-year cycle. Each topic-based issue contains around 200 pages of practical, evidence-based review articles, which integrate the results from the latest original research with current clinical practice and thinking to provide a continuous update. Each issue follows a problem-orientated approach that focuses on the key questions to be addressed, clearly defining what is known and not known. The review articles seek to address the clinical issues of diagnosis, treatment and patient management. Management is described in practical terms so that it can be applied to the individual patient. The serial is aimed at the physician in both practice and training.
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