Immune checkpoint inhibitor-mediated polymyalgia rheumatica versus primary polymyalgia rheumatica: Comparison of disease characteristics and treatment requirement

Olof C.B. Vermeulen; Elisabeth Brouwer; Riemer H.J.A. Slart; Maria Sandovici; Abraham Rutgers; T. Jeroen Hilterman; Birgitta Hiddinga; Sjoukje F. Oosting; Mathilde Jalving; Albert H. de Heij; Daan G. Knapen; Geke A.P. Hospers; Kornelis S.M. van der Geest

doi:10.1093/rheumatology/keae099

Immune checkpoint inhibitor-mediated polymyalgia rheumatica versus primary polymyalgia rheumatica: Comparison of disease characteristics and treatment requirement

Olof C.B. Vermeulen, Elisabeth Brouwer, Riemer H.J.A. Slart, Maria Sandovici, Abraham Rutgers, T. Jeroen Hilterman, Birgitta Hiddinga, Sjoukje F. Oosting, Mathilde Jalving, Albert H. de Heij, Daan G. Knapen, Geke A.P. Hospers, Kornelis S.M. van der Geest^*

^*Corresponding author for this work

Biomedical Photonic Imaging

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Abstract

Objectives: To compare clinical characteristics, imaging findings and treatment requirements of patients with immune checkpoint inhibitor-mediated polymyalgia rheumatica (ICI-PMR) and primary PMR.
Methods: This single centre, retrospective cohort study compared ICI-PMR in patients with cancer (n = 15) to patients with primary PMR (n = 37). A comparison was made between clinical symptoms, laboratory markers, ultrasonography, 18F-FDG-PET/CT findings and treatment requirements related to PMR.
Results: Patients with ICI-PMR less frequently fulfilled the EULAR/ACR classification criteria for PMR (66.7%) than patients with primary PMR (97.3%). Morning stiffness, weight loss and elevation of the ESR were less frequently seen in patients with ICI-PMR. No differences were observed regarding the presence of inflammatory lesions on ultrasound of the shoulders and hips between the two groups. The Leuven and the Leuven/Groningen 18F-FDG-PET/CT scores were significantly lower in the ICI-PMR group. Finally, the ICI-PMR group could be managed with lower glucocorticoid doses than the primary PMR group, while this treatment could be discontinued more quickly.
Conclusion: Our findings indicate that ICI-PMR may have a milder course with less intense inflammation than primary PMR. ICI-PMR can be managed with a relatively low glucocorticoid dose. Our study underscores that ICI-PMR should be regarded as a PMR-like syndrome.

Original language	English
Number of pages	9
Journal	Rheumatology
Early online date	9 Feb 2024
DOIs	https://doi.org/10.1093/rheumatology/keae099
Publication status	E-pub ahead of print/First online - 9 Feb 2024

Keywords

Immune Checkpoint Inhibitor
Immune Related Adverse Events
Immunotherapy
Polymyalgia Rheumatica

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Vermeulen, O. C. B., Brouwer, E., Slart, R. H. J. A., Sandovici, M., Rutgers, A., Hilterman, T. J., Hiddinga, B., Oosting, S. F., Jalving, M., de Heij, A. H., Knapen, D. G., Hospers, G. A. P., & van der Geest, K. S. M. (2024). Immune checkpoint inhibitor-mediated polymyalgia rheumatica versus primary polymyalgia rheumatica: Comparison of disease characteristics and treatment requirement. Rheumatology. Advance online publication. https://doi.org/10.1093/rheumatology/keae099

@article{e47919aca9ff40ce86461faa13709d5c,

title = "Immune checkpoint inhibitor-mediated polymyalgia rheumatica versus primary polymyalgia rheumatica: Comparison of disease characteristics and treatment requirement",

abstract = "Objectives: To compare clinical characteristics, imaging findings and treatment requirements of patients with immune checkpoint inhibitor-mediated polymyalgia rheumatica (ICI-PMR) and primary PMR.Methods: This single centre, retrospective cohort study compared ICI-PMR in patients with cancer (n = 15) to patients with primary PMR (n = 37). A comparison was made between clinical symptoms, laboratory markers, ultrasonography, 18F-FDG-PET/CT findings and treatment requirements related to PMR.Results: Patients with ICI-PMR less frequently fulfilled the EULAR/ACR classification criteria for PMR (66.7%) than patients with primary PMR (97.3%). Morning stiffness, weight loss and elevation of the ESR were less frequently seen in patients with ICI-PMR. No differences were observed regarding the presence of inflammatory lesions on ultrasound of the shoulders and hips between the two groups. The Leuven and the Leuven/Groningen 18F-FDG-PET/CT scores were significantly lower in the ICI-PMR group. Finally, the ICI-PMR group could be managed with lower glucocorticoid doses than the primary PMR group, while this treatment could be discontinued more quickly.Conclusion: Our findings indicate that ICI-PMR may have a milder course with less intense inflammation than primary PMR. ICI-PMR can be managed with a relatively low glucocorticoid dose. Our study underscores that ICI-PMR should be regarded as a PMR-like syndrome.",

keywords = "Immune Checkpoint Inhibitor, Immune Related Adverse Events, Immunotherapy, Polymyalgia Rheumatica",

author = "Vermeulen, {Olof C.B.} and Elisabeth Brouwer and Slart, {Riemer H.J.A.} and Maria Sandovici and Abraham Rutgers and Hilterman, {T. Jeroen} and Birgitta Hiddinga and Oosting, {Sjoukje F.} and Mathilde Jalving and {de Heij}, {Albert H.} and Knapen, {Daan G.} and Hospers, {Geke A.P.} and {van der Geest}, {Kornelis S.M.}",

year = "2024",

month = feb,

day = "9",

doi = "10.1093/rheumatology/keae099",

language = "English",

journal = "Rheumatology",

issn = "1462-0324",

publisher = "Oxford University Press",

}

Vermeulen, OCB, Brouwer, E, Slart, RHJA, Sandovici, M, Rutgers, A, Hilterman, TJ, Hiddinga, B, Oosting, SF, Jalving, M, de Heij, AH, Knapen, DG, Hospers, GAP & van der Geest, KSM 2024, 'Immune checkpoint inhibitor-mediated polymyalgia rheumatica versus primary polymyalgia rheumatica: Comparison of disease characteristics and treatment requirement', Rheumatology. https://doi.org/10.1093/rheumatology/keae099

TY - JOUR

T1 - Immune checkpoint inhibitor-mediated polymyalgia rheumatica versus primary polymyalgia rheumatica

T2 - Comparison of disease characteristics and treatment requirement

AU - Vermeulen, Olof C.B.

AU - Brouwer, Elisabeth

AU - Slart, Riemer H.J.A.

AU - Sandovici, Maria

AU - Rutgers, Abraham

AU - Hilterman, T. Jeroen

AU - Hiddinga, Birgitta

AU - Oosting, Sjoukje F.

AU - Jalving, Mathilde

AU - de Heij, Albert H.

AU - Knapen, Daan G.

AU - Hospers, Geke A.P.

AU - van der Geest, Kornelis S.M.

PY - 2024/2/9

Y1 - 2024/2/9

N2 - Objectives: To compare clinical characteristics, imaging findings and treatment requirements of patients with immune checkpoint inhibitor-mediated polymyalgia rheumatica (ICI-PMR) and primary PMR.Methods: This single centre, retrospective cohort study compared ICI-PMR in patients with cancer (n = 15) to patients with primary PMR (n = 37). A comparison was made between clinical symptoms, laboratory markers, ultrasonography, 18F-FDG-PET/CT findings and treatment requirements related to PMR.Results: Patients with ICI-PMR less frequently fulfilled the EULAR/ACR classification criteria for PMR (66.7%) than patients with primary PMR (97.3%). Morning stiffness, weight loss and elevation of the ESR were less frequently seen in patients with ICI-PMR. No differences were observed regarding the presence of inflammatory lesions on ultrasound of the shoulders and hips between the two groups. The Leuven and the Leuven/Groningen 18F-FDG-PET/CT scores were significantly lower in the ICI-PMR group. Finally, the ICI-PMR group could be managed with lower glucocorticoid doses than the primary PMR group, while this treatment could be discontinued more quickly.Conclusion: Our findings indicate that ICI-PMR may have a milder course with less intense inflammation than primary PMR. ICI-PMR can be managed with a relatively low glucocorticoid dose. Our study underscores that ICI-PMR should be regarded as a PMR-like syndrome.

AB - Objectives: To compare clinical characteristics, imaging findings and treatment requirements of patients with immune checkpoint inhibitor-mediated polymyalgia rheumatica (ICI-PMR) and primary PMR.Methods: This single centre, retrospective cohort study compared ICI-PMR in patients with cancer (n = 15) to patients with primary PMR (n = 37). A comparison was made between clinical symptoms, laboratory markers, ultrasonography, 18F-FDG-PET/CT findings and treatment requirements related to PMR.Results: Patients with ICI-PMR less frequently fulfilled the EULAR/ACR classification criteria for PMR (66.7%) than patients with primary PMR (97.3%). Morning stiffness, weight loss and elevation of the ESR were less frequently seen in patients with ICI-PMR. No differences were observed regarding the presence of inflammatory lesions on ultrasound of the shoulders and hips between the two groups. The Leuven and the Leuven/Groningen 18F-FDG-PET/CT scores were significantly lower in the ICI-PMR group. Finally, the ICI-PMR group could be managed with lower glucocorticoid doses than the primary PMR group, while this treatment could be discontinued more quickly.Conclusion: Our findings indicate that ICI-PMR may have a milder course with less intense inflammation than primary PMR. ICI-PMR can be managed with a relatively low glucocorticoid dose. Our study underscores that ICI-PMR should be regarded as a PMR-like syndrome.

KW - Immune Checkpoint Inhibitor

KW - Immune Related Adverse Events

KW - Immunotherapy

KW - Polymyalgia Rheumatica

U2 - 10.1093/rheumatology/keae099

DO - 10.1093/rheumatology/keae099

M3 - Article

C2 - 38335930

SN - 1462-0324

JO - Rheumatology

JF - Rheumatology

ER -

Immune checkpoint inhibitor-mediated polymyalgia rheumatica versus primary polymyalgia rheumatica: Comparison of disease characteristics and treatment requirement

Abstract

Keywords

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