Annals of the rheumatic diseases · 2026
Oral glucocorticoid treatment for checkpoint inhibitor-associated inflammatory arthritis does not affect cancer progression-free survival: a RADIOS Registry study.
СтатьяНаблюдательное исследованиеМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Jannat-Khah Deanna P, Reid Pankti, Cappelli Laura C, Suarez-Almazor Maria E, Abdel-Wahab Noha, Sparks Jeffrey A, Braaten Tawnie J, Meara Alexa, Nong Minerva, Ge Kyle, Katsumoto Tamiko R, Calabrese Cassandra, Tison Alice, Chan Karmela, Ghosh Nilasha, Shah Ami A, Bingham Clifton, Bass Anne R
Аннотация
OBJECTIVES: Glucocorticoids are the first-line treatment for immune checkpoint inhibitor-associated inflammatory arthritis (ICI-IA). However, glucocorticoids may negatively impact cancer progression-free survival (PFS). We investigated the association between glucocorticoids and PFS among patients with cancer with ICI-IA.
METHODS: Data from the prospective multicentre rheumatic adverse events due to Immunotherapy Observational Study registry were used. Kaplan-Meier plots and multivariable Cox regression models (time-varying and landmark) assessed glucocorticoid dose and its association with PFS. Participants who progressed before glucocorticoid initiation were excluded from the landmark analysis.
RESULTS: Participants with ICI-IA (N = 269) had a mean age of 64.85 years (SD: 12.87), 48.3% were female, 87% were White, 32% had melanoma, and most were stage IV (56.4%). In the first month of treatment, the median glucocorticoid dose (prednisone equivalent) was 13 mg daily and 7.8% of participants received an immunomodulatory disease-modifying antirheumatic drug. Cancer progression occurred in 67 participants (24.9%). In a time-varying Cox model, glucocorticoids were not associated with PFS (adjusted hazard ratio [aHR]: 2.64 [95% CI: 0.36-19.61]). Glucocorticoid doses above the median compared with below the median in the first month of ICI-IA treatment were not associated with worse PFS in adjusted Cox models (aHR: 1.15 [95% CI: 0.59-2.25]).
CONCLUSIONS: In this prospective ICI-IA cohort, low doses of glucocorticoids (median dose 13 mg [IQR: 7.5, 25] in the first month of treatment) did not adversely affect PFS.
METHODS: Data from the prospective multicentre rheumatic adverse events due to Immunotherapy Observational Study registry were used. Kaplan-Meier plots and multivariable Cox regression models (time-varying and landmark) assessed glucocorticoid dose and its association with PFS. Participants who progressed before glucocorticoid initiation were excluded from the landmark analysis.
RESULTS: Participants with ICI-IA (N = 269) had a mean age of 64.85 years (SD: 12.87), 48.3% were female, 87% were White, 32% had melanoma, and most were stage IV (56.4%). In the first month of treatment, the median glucocorticoid dose (prednisone equivalent) was 13 mg daily and 7.8% of participants received an immunomodulatory disease-modifying antirheumatic drug. Cancer progression occurred in 67 participants (24.9%). In a time-varying Cox model, glucocorticoids were not associated with PFS (adjusted hazard ratio [aHR]: 2.64 [95% CI: 0.36-19.61]). Glucocorticoid doses above the median compared with below the median in the first month of ICI-IA treatment were not associated with worse PFS in adjusted Cox models (aHR: 1.15 [95% CI: 0.59-2.25]).
CONCLUSIONS: In this prospective ICI-IA cohort, low doses of glucocorticoids (median dose 13 mg [IQR: 7.5, 25] in the first month of treatment) did not adversely affect PFS.