据报道,越来越多的患者接受免疫检查点抑制剂(ICIs)治疗,但目前对皮肤免疫相关不良事件(irAEs)的认识有限.
为了确定累积发病率,分布,ICI开始后皮肤iRAE的危险因素。
这是一项针对国家保险索赔数据库中患者的回顾性队列研究,包括接受ICIs治疗的癌症患者和匹配的对照。
该研究包括8637名ICI患者和8637名匹配的对照。皮肤irAE的总发生率为25.1%,中位发病时间为113天。ICI组瘙痒发生率明显较高,粘膜炎,红皮病,斑丘疹,白癜风,扁平苔藓,大疱性类天疱疮,Grover病,皮疹,其他非特异性喷发,和药疹或其他非特异性药物反应。患有黑色素瘤和肾细胞癌的患者以及接受联合治疗的患者发生皮肤irAE的风险较高。
无法获得患者图表数据的回顾性设计。
这项研究在现实世界的临床环境中识别了皮肤irAE,并突出了特别有风险的患者群体。结果可以帮助床边的皮肤科医生诊断皮肤irAE,并为继续ICI治疗的肿瘤学家制定管理建议。
A variety of dermatoses have been reported in the growing number of patients treated with immune-checkpoint inhibitors (ICIs), but the current understanding of cutaneous immune-related adverse events (irAEs) is limited.
To determine the cumulative incidence, distribution, and risk factors of cutaneous irAEs after ICI initiation.
This was a retrospective cohort study of patients in a national insurance claims database including cancer patients treated with ICIs and matched controls.
The study included 8637 ICI patients and 8637 matched controls. The overall incidence of cutaneous irAEs was 25.1%, with a median onset time of 113 days. The ICI group had a significantly higher incidence of pruritus, mucositis, erythroderma, maculopapular eruption, vitiligo, lichen planus, bullous pemphigoid, Grover disease, rash, other nonspecific eruptions, and drug eruption or other nonspecific drug reaction. Patients with melanoma and renal cell carcinoma and those receiving combination therapy were at a higher risk of cutaneous irAEs.
Retrospective design without access to patient chart data.
This study identifies cutaneous irAEs in a real-world clinical setting and highlights patient groups that are particularly at risk. The results can aid dermatologists at the bedside in the diagnosis of cutaneous irAEs and in formulating management recommendations to referring oncologists regarding the continuation of ICI therapy.