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Immune checkpoint inhibitors-associated vasculitis: a heterogeneous condition with possible severe disease course

Objective To describe presentation, treatment and outcome of immune checkpoint inhibitor (ICI) associated-vasculitis in cancer patients in a multicentre study.Methods Thanks to the ImmunoCancer International Registry (ICIR), a multidisciplinary network focused on the research of the immune related a...

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Main Authors: Chanson, Noémie (Author) , Galvagni, Alexandre (Author) , Ramos-Casals, Manuel (Author) , Ruiz, Juan Ignacio (Author) , Suijkerbuijk, Karijn P. M. (Author) , Gente, Karolina (Author) , Kerschen, Philippe (Author) , Karam, Jean Denis (Author) , Belkhir, Rakiba (Author) , Outh, Rodereau (Author) , Closs-Prophette, Fabienne (Author) , Morillo, Jose Salvador Garcia (Author) , Robles-Marhuenda, Angel (Author) , Michot, Jean-Marie (Author) , Voisin, Anne Laure (Author) , Messayke, Sabine (Author) , Laparra, Arianne (Author) , Robert, Caroline (Author) , Suarez-Almazor, Maria (Author) , Mariette, Xavier (Author) , Lambotte, Olivier (Author)
Format: Article (Journal)
Language:English
Published: June 2025
In: Rheumatology
Year: 2025, Volume: 64, Issue: 6, Pages: 3685-3690
ISSN:1462-0332
DOI:10.1093/rheumatology/keae711
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1093/rheumatology/keae711
Verlag, lizenzpflichtig, Volltext: https://academic.oup.com/rheumatology/article/64/6/3685/7931521
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Author Notes:Noemie Chanson, Alexandre Galvagni, Manuel Ramos-Casals, Juan Ignacio Ruiz, Karijn P. M. Suijkerbuijk, Karolina Gente, Philippe Kerschen, Jean Denis Karam, Rakiba Belkhir, Rodereau Outh, Fabienne Closs-Prophette, Jose Salvador Garcia Morillo, Angel Robles-Marhuenda, Jean-Marie Michot, Anne Laure Voisin, Sabine Messayke, Arianne Laparra, Caroline Robert, Maria Suarez-Almazor, Xavier Mariette, Olivier Lambotte, for the ICIR
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Summary:Objective To describe presentation, treatment and outcome of immune checkpoint inhibitor (ICI) associated-vasculitis in cancer patients in a multicentre study.Methods Thanks to the ImmunoCancer International Registry (ICIR), a multidisciplinary network focused on the research of the immune related adverse events related to cancer immunotherapies, patients presenting with a clinical and/or radiological suspicion of vasculitis and histological evidence of vasculitis after being exposed to ICIs were retrospectively identified.Results Twenty-eight cases were identified in the ICIR registry. The median interval between starting ICI treatment and vasculitis diagnosis was 4 months. Small vessel vasculitis was predominant (n = 21), followed by large vessel (n = 4) and medium vessel (n = 3). The small vessel vasculitis included 10 unclassified vasculitis either with limited cutaneous involvement (n = 6) or systemic involvement (n = 4), five IgA vasculitis, three cryoglobulinemic vasculitis, and three ANCA+ vasculitis. At presentation or during the evolution, renal and neurologic manifestations were evidenced in seven cases each (25%). Renal biopsies documented immune glomerulopathies in six cases. Only seven patients (25%) fulfilled the 2022 ACR/EULAR classification criteria (four giant cell arteritis, two EGPA and one GPA). Most patients (90%) required systemic corticosteroid and an additional drug was given in 10 patients (36%). Vasculitis outcome was good: 22 patients had vasculitis complete response, no patient died due to vasculitis. Nine patients (32%) were rechallenged with immunotherapy with only one relapse.Conclusion ICI-associated vasculitis are rare, heterogeneous, but can be severe requiring urgent multidisciplinary management with aggressive treatment.
Item Description:Gesehen am 05.11.2025
Physical Description:Online Resource
ISSN:1462-0332
DOI:10.1093/rheumatology/keae711

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