Prevalence of Autoimmune Diseases in Patients Treated With Immune Checkpoint Inhibitors: An Epidemiological Study Using A Global Network of Health Care Organizations
Objective Evaluate prevalence of new onset autoimmune conditions (ACs) after commencement of immune checkpoint inhibitors (ICIs). Methods This retrospective observational study was done using TriNetX. Patients with neoplasm for which ICIs were approved were stratified into two groups based on ICI us...
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Wiley
2025-01-01
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| Series: | ACR Open Rheumatology |
| Online Access: | https://doi.org/10.1002/acr2.11787 |
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| author | Pushti Khandwala Devashish Desai Arthur Lau |
| author_facet | Pushti Khandwala Devashish Desai Arthur Lau |
| author_sort | Pushti Khandwala |
| collection | DOAJ |
| description | Objective Evaluate prevalence of new onset autoimmune conditions (ACs) after commencement of immune checkpoint inhibitors (ICIs). Methods This retrospective observational study was done using TriNetX. Patients with neoplasm for which ICIs were approved were stratified into two groups based on ICI use. Multivariate Cox proportional hazard models and Kaplan Meier method were used to assess risk of developing ACs among the groups. Subgroup analysis was done to evaluate risk of ACs in patients receiving cytotoxic T‐lymphocyte‐associated protein 4 inhibitor (CTLA4i) versus program cell death protein 1 inhibitor (PD1i) and program death ligand 1 inhibitor (PDL1i) inhibitors and combination treatment (CT) (CTLA4 + PD1i/PDL1i) versus PD1i/PDL1i. Results Patients who received ICIs (2.03% of total population) were younger (68.7 ± 12.6 vs 71.8 ± 13.9; P < 0.001), predominantly male (54% vs 41%; P < 0.0001), and White (68% vs 58%; P < 0.0001), had lower odds of developing systemic lupus erythematosus (SLE) (0.366% vs 0.437%, odds ratio [OR] 0.837; P = 0.0005) and systemic sclerosis (0.108% vs 0.135%, OR 0.796; P = 0.0151), and had higher odds of developing rheumatoid arthritis (RA) (2.194% vs 1.752%, OR 1.258; P < 0.0001 with hazard ratio 1.746; P < 0.0001). There was no significant difference in developing vasculitis, dermatopolymyositis, and psoriatic arthritis when compared to patients who did not receive ICIs. The prevalence of ACs remained true after propensity score matching, except that there was no difference compared with the prevalence of SLE (0.37% [n = 391] vs 0.393% n = 415], OR 0.942 [0.82–1.082]; P = 0.3970). Conclusion Patients receiving ICIs have an increased risk of developing ACs, especially RA. There needs to be a high index of suspicion and awareness about ACs for prescribers of ICIs. |
| format | Article |
| id | doaj-art-a0d234dc8dbb48cdb536b02c7ff900c2 |
| institution | Kabale University |
| issn | 2578-5745 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | ACR Open Rheumatology |
| spelling | doaj-art-a0d234dc8dbb48cdb536b02c7ff900c22025-02-04T06:21:22ZengWileyACR Open Rheumatology2578-57452025-01-0171n/an/a10.1002/acr2.11787Prevalence of Autoimmune Diseases in Patients Treated With Immune Checkpoint Inhibitors: An Epidemiological Study Using A Global Network of Health Care OrganizationsPushti Khandwala0Devashish Desai1Arthur Lau2Jefferson Einstein Philadelphia Hospital Philadelphia PennsylvaniaSUNY Upstate Medical University Syracuse New YorkJefferson Einstein Philadelphia Hospital Philadelphia PennsylvaniaObjective Evaluate prevalence of new onset autoimmune conditions (ACs) after commencement of immune checkpoint inhibitors (ICIs). Methods This retrospective observational study was done using TriNetX. Patients with neoplasm for which ICIs were approved were stratified into two groups based on ICI use. Multivariate Cox proportional hazard models and Kaplan Meier method were used to assess risk of developing ACs among the groups. Subgroup analysis was done to evaluate risk of ACs in patients receiving cytotoxic T‐lymphocyte‐associated protein 4 inhibitor (CTLA4i) versus program cell death protein 1 inhibitor (PD1i) and program death ligand 1 inhibitor (PDL1i) inhibitors and combination treatment (CT) (CTLA4 + PD1i/PDL1i) versus PD1i/PDL1i. Results Patients who received ICIs (2.03% of total population) were younger (68.7 ± 12.6 vs 71.8 ± 13.9; P < 0.001), predominantly male (54% vs 41%; P < 0.0001), and White (68% vs 58%; P < 0.0001), had lower odds of developing systemic lupus erythematosus (SLE) (0.366% vs 0.437%, odds ratio [OR] 0.837; P = 0.0005) and systemic sclerosis (0.108% vs 0.135%, OR 0.796; P = 0.0151), and had higher odds of developing rheumatoid arthritis (RA) (2.194% vs 1.752%, OR 1.258; P < 0.0001 with hazard ratio 1.746; P < 0.0001). There was no significant difference in developing vasculitis, dermatopolymyositis, and psoriatic arthritis when compared to patients who did not receive ICIs. The prevalence of ACs remained true after propensity score matching, except that there was no difference compared with the prevalence of SLE (0.37% [n = 391] vs 0.393% n = 415], OR 0.942 [0.82–1.082]; P = 0.3970). Conclusion Patients receiving ICIs have an increased risk of developing ACs, especially RA. There needs to be a high index of suspicion and awareness about ACs for prescribers of ICIs.https://doi.org/10.1002/acr2.11787 |
| spellingShingle | Pushti Khandwala Devashish Desai Arthur Lau Prevalence of Autoimmune Diseases in Patients Treated With Immune Checkpoint Inhibitors: An Epidemiological Study Using A Global Network of Health Care Organizations ACR Open Rheumatology |
| title | Prevalence of Autoimmune Diseases in Patients Treated With Immune Checkpoint Inhibitors: An Epidemiological Study Using A Global Network of Health Care Organizations |
| title_full | Prevalence of Autoimmune Diseases in Patients Treated With Immune Checkpoint Inhibitors: An Epidemiological Study Using A Global Network of Health Care Organizations |
| title_fullStr | Prevalence of Autoimmune Diseases in Patients Treated With Immune Checkpoint Inhibitors: An Epidemiological Study Using A Global Network of Health Care Organizations |
| title_full_unstemmed | Prevalence of Autoimmune Diseases in Patients Treated With Immune Checkpoint Inhibitors: An Epidemiological Study Using A Global Network of Health Care Organizations |
| title_short | Prevalence of Autoimmune Diseases in Patients Treated With Immune Checkpoint Inhibitors: An Epidemiological Study Using A Global Network of Health Care Organizations |
| title_sort | prevalence of autoimmune diseases in patients treated with immune checkpoint inhibitors an epidemiological study using a global network of health care organizations |
| url | https://doi.org/10.1002/acr2.11787 |
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