Patients with checkpoint inhibitor-induced inflammatory arthritis do not become seropositive for anti-cyclic citrullinated peptide when followed over time.
Patients with checkpoint inhibitor-induced inflammatory arthritis do not become seropositive for anti-cyclic citrullinated peptide when followed over time.
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DOI：
10.1002/acr2.11363
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发表时间：
2022-01
影响因子：
3.4
通讯作者：
Bingham CO
中科院分区：
文献类型：
--
作者：
Cappelli LC;Darrah E;Shah AA;Bingham CO
免疫检查点抑制剂（ICI）增强了许多晚期和转移性癌症的治疗（1）。风湿病学家越来越多地遇到ICI治疗引起的免疫相关不良事件（irAE），最常见的是炎症性关节炎（IA）（2）。大多数ICI诱导IA患者（在一项系统性综述中超过90%）在关节炎出现时经典类风湿关节炎（RA）相关自身抗体（即抗环瓜氨酸肽[抗CCP]抗体）呈血清阴性。鉴于ICI诱导的IA是早期IA的潜在模型，自身抗体应答如何随时间演变具有重要意义。相当一部分ICI诱导的IA患者即使在ICI停止后仍会有持续的症状（4）。目前尚不清楚ICI治疗后持续IA症状的患者是否保持血清阴性或是否随时间发生血清转化。我们的目的是确定连续观察ICI诱导的IA的患者是否会产生抗CCP抗体。患者参与了一项风湿性irAE的纵向观察研究（由约翰霍普金斯机构审查委员会批准，IRB 00123172）。作为这项正在进行的研究的一部分，收集了临床数据，包括癌症病史和治疗、临床获得的实验室研究和疾病活动测量。对34名具有基线血样（定义为首次到风湿病诊所就诊）和至少一份随访血样的患者进行抗CCP抗体检测（QUANTA Lite环瓜氨酸肽3免疫球蛋白G酶联免疫测定法[ELISA]; Inova）。18例患者在首次就诊后接受了两次血液样本检查，6例患者在首次就诊后接受了三次血液样本检查，1例患者接受了四次血液样本检查。对纳入患者的所有可用纵向样本进行检测。
Immune checkpoint inhibitors (ICIs) have enhanced the treatment of many advanced and metastatic cancers (1). Rheumatologists are increasingly encountering immune-related adverse events (irAEs) caused by ICI treatment, most commonly inflammatory arthritis (IA)(2). The majority of patients with ICI-induced IA, more than 90% in one systematic review (3), are seronegative for classic rheumatoid arthritis (RA)–associated autoantibodies (ie, anti-cyclic citrullinated peptide [anti-CCP] antibodies) at the time of arthritis presentation. Given that ICI-induced IA is a potential model for early IA, how the autoantibody response evolves over time is of significant interest. A considerable proportion of patients with ICI-induced IA will have persistent symptoms even after ICI cessation (4). It is unknown whether patients with persistent IA symptoms after ICI therapy remain seronegative or whether they seroconvert over time. We aimed to determine whether patients observed serially for ICI-induced IA would develop anti-CCP antibodies.Patients were participants in a longitudinal observational study of rheumatic irAEs (approved by Johns Hopkins Institutional Review Board, IRB00123172). Clinical data, including cancer history and treatment, clinically obtained laboratory studies, and disease activity measures, were collected as part of this ongoing study. Thirty-four patients with a baseline blood sample (defined as the first presentation to the rheumatology clinic) and at least one follow-up blood sample were tested for anti-CCP antibodies (QUANTA Lite cyclic citrullinated peptide 3 immunoglobulin G enzyme-linked immunoassay [ELISA]; Inova). Eighteen patients had two blood samples taken at visits after their initial presentation to rheumatology, six patients had three subsequent blood samples after initial presentation, and one patient had four subsequent samples. All available longitudinal samples were tested for included patients.
影响因子：
27.4
作者：
Braaten, Tawnie J.;Brahmer, Julie R.;Cappelli, Laura C.
通讯作者：
Cappelli, Laura C.
影响因子：
50.3
作者：
Topalian SL;Drake CG;Pardoll DM
通讯作者：
Pardoll DM
影响因子：
4.2
作者：
Gardette, Anais;Ottaviani, Sebastien;Dieude, Philippe
通讯作者：
Dieude, Philippe