Vasculitis & polymyalgia rheumatica
Immune checkpoint inhibitors–induced large vessel vasculitis: clinical characteristics and management from a European multicentre study
Authors' conclusion
ICI-induced LVV is a rare, early-onset IrAE. Although continuation of ICIs may affect LVV outcomes, cancer progression remains the primary cause of mortality.
Study context
- Population
- Adults who developed large vessel vasculitis (LVV) (defined histologically and/or morphologically) after ICI therapy, European multicentre, March 2018–August 2024median age 68 (61–74) years
- Participants
- 27 adults
- Exposure
- ICI-induced LVV vs matched controls with primary LVV
- ICI-induced LVVn = 27
- Outcome
- Clinical characteristics and evolution of ICI-induced LVV compared with primary LVV
Methodological detailsmulticentre, European, matched controls with primary LVV
- Multicentre
- European
- Matched controls with primary LVV
Main finding
As reported in the abstract
Median time from ICI initiation to LVV diagnosis, months (IQR)
3
2–17
Ipilimumab-nivolumab combination therapy, all developed LVV within 6 months
8
30%
Observational data: associations, not effects.
Further findings
Management: discontinuation of immune checkpoint inhibitors (ICIs)
- ICIs discontinued
- 19 (70%)
- And administration of GC
Sustained remission · median follow-up of 12 (5-20) months
- Achieved sustained remission
- 20 (74%)
Relapse or treatment failure of LVV, by ICI continuation
- Continued ICIs
- 3/9 (33%)
- Discontinued ICIs
- 4/18 (22%)
Death by last follow-up
- Died
- 9 (33%)
- Deaths mainly from cancer
- 8
Comparison with matched primary LVV controls
- Most clinical features similar to matched controls; PET scan diagnosis and large-vessel involvement more common in ICI-induced LVV
Original publication
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