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.
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.
Decoding the Patent Puzzle: Navigating the Legal Landscape of Biosimilars
March 17th 2024On this episode of Not So Different, Ha Kung Wong, JD, an intellectual patent attorney and partner at Venable LLP, details the confusing landscape that is the US patent system and how it can be improved to help companies overcome barriers to biosimilar competition.
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.
Exploring the Biosimilar Horizon: Julie Reed's Predictions for 2024
February 18th 2024On this episode of Not So Different, Julie Reed, executive director of the Biosimilars Forum, returns to discuss her predictions for the biosimilar industry for 2024 and beyond as well as the impact that the Forum's 4 new members will have on the organization's mission.