Risk of scleroderma according to the type of immune checkpoint inhibitors.

Abstract:

INTRODUCTION:Immune checkpoint inhibitors (ICIs) are associated with immune-related adverse events (irAEs). Among them, ICIs-induced systemic sclerosis (SSc) is poorly known. METHODS:To better characterize this irAE, our comprehensive approach combined the description of ICIs-induced scleroderma cases, the systematic review of the literature and the analysis of VigiBase, the WHO pharmacovigilance database. RESULTS:We identified two cases with underlying limited cutaneous SSc who presented a dramatic increase in the skin thickening following pembrolizumab, associated with scleroderma renal crisis in one case. In the literature, four cases of scleroderma and four cases of morphea have been reported with pembrolizumab or nivolumab. None following ipilimumab, atezolizumab or durvalumab were retrieved. Skin changes appeared or worsened more quickly with pembrolizumab than nivolumab, and had different patterns between both drugs. Patients with generalized skin changes required high-dose prednisone to improve skin thickening. Among the 2527 scleroderma cases identified in VigiBase, 35 were associated with ICIs. Nivolumab and pembrolizumab showed a disproportionality in scleroderma reporting. No disproportionality was found for ipilimumab, atezolizumab or durvalumab. CONCLUSION:The risk of scleroderma or fibrosis extension in SSc patients should be considered when initiating anti-PD-1 agents. It suggests the role of PD-1/PD-L1 interaction in the pathophysiology of SSc.

journal_name

Autoimmun Rev

journal_title

Autoimmunity reviews

authors

Terrier B,Humbert S,Preta LH,Delage L,Razanamahery J,Laurent-Roussel S,Mestiri R,Beaudeau L,Legendre P,Goupil F,Hadjadj J,Stolzenberg MC,Treluyer JM,Westeel V,Valnet-Rabier MB,Wislez M,Mouthon L,Chouchana L

doi

10.1016/j.autrev.2020.102596

subject

Has Abstract

pub_date

2020-08-01 00:00:00

pages

102596

issue

8

eissn

1568-9972

issn

1873-0183

pii

S1568-9972(20)30160-9

journal_volume

19

pub_type

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