Patients exposed to checkpoint inhibitors (CPI) for cancer treatment may have a higher risk of developing non-infectious uveitis and myasthenia gravis (MG) compared with those treated with non-CPI chemotherapy, new research published online in the British Journal of Ophthalmology suggests.
The retrospective cohort study included patients in a large commercial and Medicare advantage database who underwent CPI therapy, and a control group of individuals who underwent non-CPI. All patients who initiated a CPI (ipilimumab, pembrolizumab, nivolumab, atezolizumab, avelumab, cemiplimab and durvalumab) were eligible. Every CPI patient was matched up to 1:10 based on demographics and index year to patients on non-CPI chemotherapy.
Looking at non-infectious uveitis rates, 26 (0.3%) out of 8,678 CPI patients and 123 (0.2%) of 76,153 non-CPI participants were found to have the ocular condition. In a multivariate analysis, those in the CPI group showed an increased risk of developing uveitis compared with the non-CPI group. In the MG analysis, 11 (0.1%) of 9,210 patients developed MG in the CPI group compared with 36 (0.04%) out of 80,620 in the non-CPI group. Additionally, the CPI cohort had a higher risk of developing MG (HR=2.60) compared with controls in multivariate analysis.
Xia T, Brucker AJ, McGeehan B, VanderBeek BL. Risk of non-infectious uveitis or myasthenia gravis in patients on checkpoint inhibitors in a large healthcare claims database. Br J Ophthalmol. October 21, 2020. [Epub ahead of print].