Tocilizumab provides dual benefits in treating immune checkpoint inhibitor-associated arthritis and preventing relapse during ICI rechallenge: the TAPIR study

Annals of Oncology, Год журнала: 2024, Номер unknown

Опубликована: Сен. 1, 2024

Язык: Английский

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Tocilizumab provides dual benefits in treating immune checkpoint inhibitor-associated arthritis and preventing relapse during ICI rechallenge: the TAPIR study

medRxiv (Cold Spring Harbor Laboratory), Год журнала: 2024, Номер unknown

Опубликована: Июль 12, 2024

Abstract Background Immune checkpoint inhibitor (ICI)-associated arthritis (ICI-AR) significantly affects quality of life and often requires discontinuation ICI therapy initiation immunosuppressive treatment. The aim this retrospective study was to evaluate the dual efficacy tocilizumab (TCZ), an anti-IL-6R agent, in treatment ICI-AR prevention relapses after rechallenge. Methods This single-center conducted at our institution from 2020 end 2023. We identified 26 patients who developed ICI-AR. primary objectives were therapeutic TCZ potential as secondary prophylaxis during rechallenge 11 them. For ICI-AR, received prednisone (CS) a low dose 0.3 mg/kg tapered 0.05 weekly for six weeks until discontinuation. administered 8 every two weeks. In subgroup receiving (rechallenge n=11, 10 patients), reintroduced same dosage bi-weekly concurrently with rechallenge, without addition CS. A control group n=5, 3 patients) rechallenged TCZ. Secondary endpoints included post evaluation duration, reintroduction CS > 0.1 mg/kg/day, ICI-RA flares, disease rate (DCR). An additional explanatory endpoint identification biomarkers predictive response Results median age 70 years. follow-up 864 days. regimens anti-PD-(L)1 monotherapy 17 (63%), anti-PD-1 combined anti-CTLA4 (31%), anti-LAG3 1 patient (4%). Among 20 treated all (100%) achieved ACR70 rate, defined greater than 70% improvement, Additionally, 81% these steroid-free remission 24 on period 552 days patients. (n=16) thirteen cases (81%) combination three (19%). results demonstrated reduction upon compared did not receive (17% vs 40%). addition, requirement doses exceeding mg/kg/day completely abolished (0% 20%), mean duration notably extended 113 206 12-month post-rechallenge outcomes showed (DCR) 77%. Importantly, prophylaxis, CXCL9 levels remained elevated, showing no decline their onset elevations IL-6 CXCL10 exclusively observed new irAEs prophylaxis. Conclusion its treating prophylactic preventing recurrence symptoms lengthening use may represent promising strategy extend exposure treatments maximize benefit. Highlights 1- 100% weeks, demonstrating ICI-RA. 2- significant status TCZ, underscoring utility accelerating tapering. 3- serves successful ICI, flares need use. 4- reduces time by 47.5 extends uninterrupted 93 5- reduced suggesting that there negative impact cytokines associated oncologic response. early increases signal

Язык: Английский

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Difficult-to-treat Takayasu arteritis: a case-based review

Rheumatology International, Год журнала: 2024, Номер unknown

Опубликована: Окт. 23, 2024

Язык: Английский

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Redefining giant cell arteritis: From current practices to future paradigms

European Journal of Internal Medicine, Год журнала: 2024, Номер 132, С. 37 - 39

Опубликована: Дек. 10, 2024

Язык: Английский

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