A recent study published in Cancer Medicine has highlighted the increased risk of developing myasthenia gravis (MG), myasthenic syndrome, and myasthenia crisis in patients undergoing immune checkpoint inhibition (ICI) treatment for various types of cancers. The study utilized data from the US FDA Adverse Event Reporting System (FAERS) to analyze adverse events (AEs) related to specific drugs used in ICI treatment.
The findings of the study revealed that all six drugs analyzed - durvalumab, atezolizumab, pembrolizumab, nivolumab, avelumab, and ipilimumab - showed statistically significant associations with an increased risk of myasthenic syndrome and MG. The proportional reporting odds ratios (PRR) and chi-square (χ2) results were above the threshold for statistical significance. The drugs pembrolizumab and nivolumab were found to have the highest risk signals for developing myasthenia crisis.
The study emphasizes the importance of closely monitoring patients undergoing ICI treatment, particularly those receiving pembrolizumab and nivolumab, for any signs or symptoms of MG. The authors highlight the need for vigilance and consideration of alternative treatment options when appropriate.
It should be noted that the study does not suggest that the use of immunosuppressive drugs should be avoided, but rather underscores the necessity for close monitoring and awareness of potential adverse events when these drugs are used in combination.
The findings of this study provide valuable insights for the safe and rational clinical use of drugs by utilizing signal detection methods to identify potential risk signals. Such analysis assists in overcoming the limitations of clinical trials, which may have limited sample size and duration of follow-up.
Ultimately, this research serves as a reminder of the importance of patient safety and the need for comprehensive monitoring and management of potential adverse events associated with ICI treatment.
Reference:
- Kong Q, Wang H, Ren X, Zahuo Y, Peng J. Analysis on the risk of myasthenia gravis related to immune checkpoint inhibitors based on the US FDA Adverse Event Reporting System. Cancer Med. Published online September 19, 2023. doi:10.1002/cam4.6559