| アブストラクト | Myasthenia gravis (MG) is a rare but fatal adverse event of immune checkpoint inhibitors (ICIs). We assessed whether patient characteristics differed between those with ICI-related myasthenia gravis and those with idiopathic myasthenia gravis. Reports from the US Food and Drug Administration Adverse Event Reporting System were analyzed. Multivariate analyses were conducted to evaluate the associations between age, sex, and ICI treatment and the reporting rate of myasthenia gravis. Among 5 464 099 cases between 2011 and 2019, 53 447 were treated with ICIs. Myasthenia gravis was reported more often in ICI users. Multiple logistic regression analyses showed that the reporting rate of ICI-related myasthenia gravis did not differ significantly between men and women; however, it was higher in older people than in younger people (adjusted odds ratio, 2.4 [95%CI, 1.84-3.13]). We also investigated useful signs for the early detection of myositis and myocarditis, which are fatal when overlapping with ICI-related myasthenia gravis. Patients with elevated serum creatine kinase or troponin levels were more likely to have concurrent myositis and myocarditis. Unlike idiopathic myasthenia gravis, there was no sex difference in the development of ICI-related myasthenia gravis, which may be more common in older people. Considering the physiological muscle weakness that occurs in the elderly, it may be necessary to monitor ICI-related myasthenia gravis more closely in older people. |
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| 投稿者 | Niimura, Takahiro; Zamami, Yoshito; Miyata, Koji; Mikami, Takahisa; Asada, Mizuho; Fukushima, Keijo; Yoshino, Masaki; Mitsuboshi, Satoru; Okada, Naoto; Hamano, Hirofumi; Sakurada, Takumi; Matsuoka-Ando, Rie; Aizawa, Fuka; Yagi, Kenta; Goda, Mitsuhiro; Chuma, Masayuki; Koyama, Toshihiro; Izawa-Ishizawa, Yuki; Yanagawa, Hiroaki; Fujino, Hiromichi; Yamanishi, Yoshihiro; Ishizawa, Keisuke |
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| 組織名 | Department of Clinical Pharmacology and Therapeutics, Tokushima University;Graduate School of Biomedical Sciences, Tokushima, Japan.;Clinical Research Center for Developmental Therapeutics, Tokushima University;Hospital, Tokushima, Japan.;Department of Pharmacy, Okayama University Hospital, Okayama, Japan.;Department of Neurology, Tufts Medical Center, Boston, Massachusetts, USA.;Department of Pharmacy, Tokyo Medical and Dental University Hospital, Tokyo;Medical and Dental University, Tokyo, Japan.;Department of Medical Molecular Informatics, Meiji Pharmaceutical University,;Tokyo, Japan.;Department of Pharmacology for Life Sciences, Tokushima University Graduate;School of Biomedical Sciences, Tokushima, Japan.;Department of Pharmacy, Niigata Prefectural Cancer Center Hospital, Niigata,;Japan.;Department of Pharmacy, Kaetsu Hospital, Niigata, Japan.;Department of Pharmacy, Tokushima University Hospital, Tokushima, Japan.;Department of Hospital Pharmacy and Pharmacology, Asahikawa Medical University,;Asahikawa, Japan.;Department of Health Data Science, Graduate School of Medicine, Dentistry, and;Pharmaceutical Sciences, Okayama University, Okayama, Japan.;Department of Pharmacology, Tokushima University Graduate School of Biomedical;Sciences, Tokushima, Japan.;Faculty of Health and Welfare Department of Nursing, Tokushima Bunri University,;Tokushima, Japan.;Department of Bioscience and Bioinformatics, Faculty of Computer Science and;Systems Engineering, Kyushu Institute of Technology, Fukuoka, Japan. |
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