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Immune checkpoint inhibitor-related myositis: from pathophysiology to treatment
Chandrasekhar Sundarrajan1, Salman Bhai2, Mazen M Dimachkie3
1Department of Neurology, UT Southwestern Medical Center, Dallas, TX, USA.
Abstract:
With rapid advances in immuno-oncology, immune checkpoint inhibitors (ICIs) are increasingly used for a broad array of malignancies. This has led to a novel spectrum of adverse effects including ICI-related myositis, a potentially life-threatening neuromuscular complication that must be diagnosed and treated promptly. Significant gaps exist in the current understanding of ICI-related myositis due to the rarity of the condition and the lack of evidence-based guidelines, prompting the need to synthesize the most relevant and recent published works in the field. This review provides a broad overview of ICI-related myositis with an emphasis on pathophysiology, epidemiology, clinical features, workup, management and future directions.
Insights
Immune checkpoint inhibitors (ICIs) can cause myositis, a rare but serious neuromuscular side effect. Prompt diagnosis and treatment are crucial for managing this potentially life-threatening condition.
Area of Science:
- Oncology
- Immunology
- Neurology
Background:
- Immuno-oncology has advanced rapidly, increasing the use of immune checkpoint inhibitors (ICIs) across various cancers.
- Immune checkpoint inhibitors (ICIs) can cause a range of adverse effects, including ICI-related myositis.
- ICI-related myositis is a rare but potentially life-threatening neuromuscular complication.
Purpose of the Study:
- To provide a comprehensive overview of ICI-related myositis.
- To synthesize recent literature on ICI-related myositis due to knowledge gaps and lack of evidence-based guidelines.
- To emphasize pathophysiology, epidemiology, clinical features, diagnosis, management, and future research directions.
Main Methods:
- Literature review of recent publications on ICI-related myositis.
- Synthesis of existing data on the condition's various aspects.
Main Results:
- ICI-related myositis presents a unique challenge due to its rarity and the absence of established guidelines.
- Understanding the pathophysiology, clinical presentation, and diagnostic workup is essential for prompt management.
- Effective treatment strategies are critical to mitigate the potentially life-threatening nature of this complication.
Conclusions:
- ICI-related myositis requires prompt diagnosis and management.
- Further research is needed to address the existing gaps in knowledge and develop evidence-based guidelines.
- A multidisciplinary approach is likely necessary for optimal patient outcomes.
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