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Review
. 2024 May;50(2):281-290.
doi: 10.1016/j.rdc.2024.02.003. Epub 2024 Mar 12.

Immune Checkpoint Inhibitor-induced Myositis

Athira Jayan  1 , Andrew L Mammen  2 , Maria E Suarez-Almazor  3
Affiliations
Review

Immune Checkpoint Inhibitor-induced Myositis

Athira Jayan et al. Rheum Dis Clin North Am. 2024 May.

Abstract

Myositis induced by immune checkpoint inhibitors (ICIs) is an infrequent, potentially fatal, immune-related adverse event. It has higher incidence in patients who receive combination ICI therapy compared to monotherapy. Patients can present with clinical manifestation symptoms of myositis alone or in combination with myocarditis and/or myasthenia gravis, which significantly worsens the course and prognosis. Diagnosis can generally be made on the basis of clinical presentation, elevation of muscle enzymes, and electromyographic changes, but some patients may require a muscle biopsy. The first line of therapy is high-dose corticosteroids, followed by immunosuppression, plasmapheresis, or intravenous immunoglobulin in patients with severe disease.

Keywords: Immune checkpoint inhibitors; Immune-related adverse events; Myasthenia gravis; Myocarditis; Myositis.

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Conflict of interest statement

Disclosure M.E. Suarez-Almazor has received consulting fees from Pfizer, Eli Lilly, Celgene, and Syneos Health in the past 12 months, unrelated to this work.

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