Anne Bass, MD, rheumatologist at the Hospital for Special Surgery and professor of clinical medicine at Weill Cornell Medicine, discusses how rheumatologists treat musculoskeletal adverse events caused by immune checkpoint inhibitors.
Transcript
Immune checkpoint inhibition for cancer therapy can result in musculoskeletal adverse events, how are these adverse effects treated in the rheumatology clinic?
So, this is a really exciting area because these immunotherapies are prolonging the lives of people with metastatic cancer who had otherwise would’ve died. They work by stimulating the immune system and allowing it to target the cancer. Not surprisingly, when you stimulate the immune system, you can cause autoimmune diseases; and that’s what we’re seeing and they take many shapes and forms. Some of the earliest ones we knew about were immunity in the skin and colitis involving the gastrointestinal track, but as time has gone on we’ve come to realize that some of these patients— probably about 5%– develop an inflammatory arthritis and it can take, again, many forms.
I think one of the reasons there was a little delay in recognition is that it may be a little bit more common with some of the newer immunotherapies that target PD-1 and PD-L1 as compared to the older therapies with CTLA4 blockers, and it's seen particularly [common] when you use those 2 groups in combination. So, patients will come to a rheumatologist as they would if they had inflammatory arthritis that developed in some other context and these patients have all different kinds of presentations. Some of them have zero-positive rheumatoid arthritis that looks for all the world like rheumatoid arthritis, others have fewer joints affected, or they have tendons that are swollen. We’ve seen polymyalgia rheumatica, and their case is almost of every rheumatic disease you can think of with these checkpoint inhibitors. There are many fewer cases of things like lupus and drama monocytes though than there are of patients with rheumatoid arthritis, psoriatic arthritis, and the inflammatory rhinitis in general.
Biosimilars in America: Overcoming Barriers and Maximizing Impact
July 21st 2024Join us as we explore the complexities of the US biosimilars market, discussing legislative influences, payer and provider adoption factors, and strategies to overcome industry challenges with expert insights from Kyle Noonan, PharmD, MS, value & access strategy manager at Cencora.
Q&A With Dr Chelsee Jensen: Navigating FDA Approvals, Challenges in the Biosimilar Landscape
January 14th 2024Chelsee Jensen, PharmD, BCPS, senior pharmacy specialist and pharmaceutical formulary manager at Mayo Clinic, reacts to the biggest FDA approvals of 2023 and how she sees the adalimumab, natalizumab, and tocilizumab spaces playing out.
Breaking Barriers in Osteoporosis Care: New Denosumab Biosimilars Wyost, Jubbonti Approved
June 16th 2024In this episode, The Center for Biosimilars® delves into the FDA approval of the first denosumab biosimilars, Wyost and Jubbonti (denosumab-bbdz), and discuss their potential to revolutionize osteoporosis treatment with expert insights from 2 rheumatologists.
IGBA 2023: Dr Monique Mansoura Highlights the Intersection of Geopolitical Issues, Biopharma
February 19th 2023COVID-19 allowed governments to critically examine the biopharma space to increase access to vaccines, but there's still a way to go, according to Monique Mansoura, PhD, MBA, executive director of global health security and biotechnology at the MITRE Corporation, at the International Generic and Biosimilar Medicines Association’s annual meeting.