TY - JOUR
T1 - Detection of novel therapies using a multi-national, multi-institutional registry of cutaneous immune-related adverse events and management
AU - Mital, Rohan
AU - Otto, Tracey S.
AU - Savu, Andrei
AU - Baumrin, Emily
AU - Cardones, Adela R.
AU - Carlesimo, Marta
AU - Caro, Gemma
AU - Freites-Martinez, Azael
AU - Hirner, Jesse P.
AU - Markova, Alina
AU - McLellan, Beth N.
AU - Rossi, Alfredo
AU - Sauder, Maxwell B.
AU - Seminario-Vidal, Lucia
AU - Sibaud, Vincent
AU - Owen, Dwight H.
AU - Dulmage, Brittany O.
AU - Chen, Steven T.
AU - Kaffenberger, Benjamin H.
N1 - Publisher Copyright:
© 2023 The Authors. International Journal of Dermatology published by Wiley Periodicals LLC on behalf of the International Society of Dermatology.
PY - 2023/8
Y1 - 2023/8
N2 - Background: Cutaneous immune-related adverse events (cirAEs) remain a prevalent and common sequelae of immune checkpoint inhibitor (ICI) therapy, often necessitating treatment interruption and prolonged immune suppression. Treatment algorithms are still poorly defined, based on single-institution case reports without adequate safety assessments, and subject to publication bias. Methods: Data in this registry were collected through a standardized REDCap form distributed to dermatologists via email listserv. Results: Ninety-seven cirAEs were reported from 13 institutions in this registry. Topical and systemic steroids were the most common treatments used; however, targeted treatment matched to disease morphology was identified at numerous sites. Novel cirAE therapy uses that to our knowledge have not been previously described were captured including tacrolimus for the treatment of follicular, bullous, and eczematous eruptions and phototherapy for eczematous eruptions. Moreover, further evidence of cirAE treatment applications sparsely described in literature were also captured in this study including dupilumab and rituximab for bullous eruptions, phototherapy for lichenoid and psoriasiform eruptions, and acitretin for psoriasiform eruptions, among others. No serious adverse events were reported. Numerous targeted therapeutics including dupilumab, rituximab, and psoriasis biologics, among others, were associated with a cirAE grade improvement of ≥2 grades in every patient treated. Conclusion: This study suggests that a multi-institutional registry of cirAEs and management is not only feasible but that the information collected can be used to detect, evaluate, and rigorously assess targeted treatments for cirAEs. Further expansion and modification to include treatment progression may allow for sufficient data for specific treatment recommendations to be made.
AB - Background: Cutaneous immune-related adverse events (cirAEs) remain a prevalent and common sequelae of immune checkpoint inhibitor (ICI) therapy, often necessitating treatment interruption and prolonged immune suppression. Treatment algorithms are still poorly defined, based on single-institution case reports without adequate safety assessments, and subject to publication bias. Methods: Data in this registry were collected through a standardized REDCap form distributed to dermatologists via email listserv. Results: Ninety-seven cirAEs were reported from 13 institutions in this registry. Topical and systemic steroids were the most common treatments used; however, targeted treatment matched to disease morphology was identified at numerous sites. Novel cirAE therapy uses that to our knowledge have not been previously described were captured including tacrolimus for the treatment of follicular, bullous, and eczematous eruptions and phototherapy for eczematous eruptions. Moreover, further evidence of cirAE treatment applications sparsely described in literature were also captured in this study including dupilumab and rituximab for bullous eruptions, phototherapy for lichenoid and psoriasiform eruptions, and acitretin for psoriasiform eruptions, among others. No serious adverse events were reported. Numerous targeted therapeutics including dupilumab, rituximab, and psoriasis biologics, among others, were associated with a cirAE grade improvement of ≥2 grades in every patient treated. Conclusion: This study suggests that a multi-institutional registry of cirAEs and management is not only feasible but that the information collected can be used to detect, evaluate, and rigorously assess targeted treatments for cirAEs. Further expansion and modification to include treatment progression may allow for sufficient data for specific treatment recommendations to be made.
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U2 - 10.1111/ijd.16714
DO - 10.1111/ijd.16714
M3 - Article
C2 - 37203799
AN - SCOPUS:85159675042
SN - 0011-9059
VL - 62
SP - 1020
EP - 1025
JO - International Journal of Dermatology
JF - International Journal of Dermatology
IS - 8
ER -