Epidemiology and risk factors for the development of cutaneous toxicities in patients treated with immune-checkpoint inhibitors: A United States population-level analysis.
Cutaneous
dermatologic
drug reactions
immune-checkpoint inhibitors
immune-related adverse events
immunotherapy
Journal
Journal of the American Academy of Dermatology
ISSN: 1097-6787
Titre abrégé: J Am Acad Dermatol
Pays: United States
ID NLM: 7907132
Informations de publication
Date de publication:
03 2022
03 2022
Historique:
received:
01
09
2020
revised:
18
03
2021
accepted:
24
03
2021
pubmed:
6
4
2021
medline:
15
4
2022
entrez:
5
4
2021
Statut:
ppublish
Résumé
A variety of dermatoses have been reported in the growing number of patients treated with immune-checkpoint inhibitors (ICIs), but the current understanding of cutaneous immune-related adverse events (irAEs) is limited. To determine the cumulative incidence, distribution, and risk factors of cutaneous irAEs after ICI initiation. This was a retrospective cohort study of patients in a national insurance claims database including cancer patients treated with ICIs and matched controls. The study included 8637 ICI patients and 8637 matched controls. The overall incidence of cutaneous irAEs was 25.1%, with a median onset time of 113 days. The ICI group had a significantly higher incidence of pruritus, mucositis, erythroderma, maculopapular eruption, vitiligo, lichen planus, bullous pemphigoid, Grover disease, rash, other nonspecific eruptions, and drug eruption or other nonspecific drug reaction. Patients with melanoma and renal cell carcinoma and those receiving combination therapy were at a higher risk of cutaneous irAEs. Retrospective design without access to patient chart data. This study identifies cutaneous irAEs in a real-world clinical setting and highlights patient groups that are particularly at risk. The results can aid dermatologists at the bedside in the diagnosis of cutaneous irAEs and in formulating management recommendations to referring oncologists regarding the continuation of ICI therapy.
Sections du résumé
BACKGROUND
A variety of dermatoses have been reported in the growing number of patients treated with immune-checkpoint inhibitors (ICIs), but the current understanding of cutaneous immune-related adverse events (irAEs) is limited.
OBJECTIVE
To determine the cumulative incidence, distribution, and risk factors of cutaneous irAEs after ICI initiation.
METHODS
This was a retrospective cohort study of patients in a national insurance claims database including cancer patients treated with ICIs and matched controls.
RESULTS
The study included 8637 ICI patients and 8637 matched controls. The overall incidence of cutaneous irAEs was 25.1%, with a median onset time of 113 days. The ICI group had a significantly higher incidence of pruritus, mucositis, erythroderma, maculopapular eruption, vitiligo, lichen planus, bullous pemphigoid, Grover disease, rash, other nonspecific eruptions, and drug eruption or other nonspecific drug reaction. Patients with melanoma and renal cell carcinoma and those receiving combination therapy were at a higher risk of cutaneous irAEs.
LIMITATIONS
Retrospective design without access to patient chart data.
CONCLUSIONS
This study identifies cutaneous irAEs in a real-world clinical setting and highlights patient groups that are particularly at risk. The results can aid dermatologists at the bedside in the diagnosis of cutaneous irAEs and in formulating management recommendations to referring oncologists regarding the continuation of ICI therapy.
Identifiants
pubmed: 33819538
pii: S0190-9622(21)00661-7
doi: 10.1016/j.jaad.2021.03.094
pmc: PMC10285344
mid: NIHMS1908299
pii:
doi:
Substances chimiques
Immune Checkpoint Inhibitors
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
563-572Subventions
Organisme : NIGMS NIH HHS
ID : T32 GM007753
Pays : United States
Organisme : NHLBI NIH HHS
ID : F30 HL142131
Pays : United States
Organisme : NCI NIH HHS
ID : L30 CA264747
Pays : United States
Organisme : NIGMS NIH HHS
ID : R35 GM142879
Pays : United States
Organisme : NIGMS NIH HHS
ID : T32 GM007309
Pays : United States
Organisme : NCI NIH HHS
ID : F30 CA224588
Pays : United States
Informations de copyright
Copyright © 2021 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of interest None disclosed.
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