Polymyalgia rheumatica-like syndrome from checkpoint inhibitor therapy: Case series and systematic review of the literature

Cassandra Calabrese, Laura C. Cappelli, Marie Kostine, Elizabeth Kirchner, Tawnie Braaten, Leonard Calabrese

Research output: Contribution to journalArticlepeer-review

Abstract

Objective To assess whether the polymyalgia rheumatica (PMR)-like syndrome reported as an immune related adverse event (irAE) from checkpoint inhibitor therapy is consistent with the 2012 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) provisional criteria for PMR. Methods The cases were derived from two sources. Group 1 represents reported cases from three contributing centres. Group 2 was derived from a systematic review of the literature searching for all cases reported as PMR or PMR-like illness associated with checkpoint inhibitor therapy. Cases were assessed for the quality of reporting and then analysed to determine whether they fulfilled the 2012 EULAR/ACR provisional criteria for PMR. Results A total of 49 patients were included for analysis. Among the entire group, 37 (75%) were designated a € complete' indicating that they had sufficient data to reliably apply the 2012 EULAR/ACR criteria. 28 (75%) cases fulfilled complete criteria for PMR. A number of cases also demonstrated some clinical features unusual for idiopathic PMR. Conclusion This study suggests a high proportion of reported cases of checkpoint inhibitor-related PMR fulfil preliminary criteria for PMR, yet in one quarter clinical details were incomplete making verification problematic. Furthermore, in the absence of a gold standard for the diagnosis of PMR, the relationship of checkpoint inhibitor-related PMR to the idiopathic form remains unclear.

Original languageEnglish (US)
Article numbere000906
JournalRMD Open
Volume5
Issue number1
DOIs
StatePublished - Apr 1 2019

Keywords

  • autoimmune diseases
  • inflammation
  • polymyalgia rheumatica

ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy
  • Immunology

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