免疫检查点抑制剂诱导的多肌痛风湿和巨细胞动脉炎:系统的文献综述,突出了与特异性形式的差异
Elvis Hysa1, Andrea Casabella2, Emanuele Gotelli3
1Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, Genoa, Italy; Department of Experimental Medicine (DIMES), University of Genova, Genoa, Italy.
Autoimmunity reviews
|August 8, 2024
概括
免疫检查点抑制剂 (ICI) 诱导的多发性肌痛风湿 (PMR) 和巨细胞动脉炎 (GCA) 可能与异常形式不同. 这些ICI诱导的疾病可能表现出较轻微的症状,对治疗反应更好,因此需要进一步调查.
科学领域:
- 类风湿病学 类风湿病学
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
背景情况:
- 免疫检查点抑制剂 (ICI) 可以改变免疫耐受性,可能导致新发多发性肌痛性风湿 (PMR) 和巨细胞动脉炎 (GCA).
- 本系统性文献综述 (SLR) 研究了ICI癌症治疗后出现的PMR和GCA综合征的特征.
研究的目的:
- 检查ICI诱导的PMR和GCA的人口,临床和与治疗相关的特征.
- 提供关于ICI诱导的类风湿综合征和其异常性对应症之间的潜在差异的见解.
主要方法:
- 在Medline,EMBASE和EULAR/ACR抽象数据库 (至2024年7月) 进行了系统的文献审查.
- 使用可用的比较研究或系统性审查,ICI诱导的PMR和GCA综合征与这些疾病的初级形式进行了比较.
主要成果:
- 该审查包括46项研究,358名患者 (314名ICI-PMR,44名ICI-GCA).
- ICI-PMR显示ICI接受者的患病率为0.1%,以炎症性腰带疼痛为特征,其中84%对葡萄糖皮质类药物有反应.
- ICI-GCA发生在0.06%的ICI接受者中,表现为脑部症状和大血管干扰,高剂量葡萄糖皮质类药物达到96%的缓解.
结论:
- 与特异性形式相比,ICI诱导的PMR和GCA可能表现出不同的临床特征,可能有较轻微的症状.
- 这些ICI相关的类风湿病似乎有良好的治疗反应,尽管需要进一步的研究来确认长期结果和病理生理学.
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