Abstract
Ipilimumab, a monoclonal antibody targeting the cytotoxic T lymphocyte antigen-4 is a treatment option for metastatic melanoma. This receptor serves as an inhibitor receptor on T lymphocytes and blockage of these results predisposition to autoimmune diseases. The patients with autoimmune disorders were excluded in clinical trials and there is no sufficient data of the treatment on these patients who already have an autoimmune disorder. Here, we report a case of myasthenia gravis who was treated with ipilimumab and we presented the long-term prognosis of the patient after treatment.
References
Bertrand A, Kostine M, Barnetche T, Truchetet ME, Schaeverbeke T (2015) Immune related adverse events associated with anti-CTLA-4 antibodies: systematic review and meta-analysis. BMC Med 13:211. https://doi.org/10.1186/s12916-015-0455-8
Johnson DB, Sullivan RJ, Ott PA, Carlino MS, Khushalani NI, Ye F, Guminski A, Puzanov I, Lawrence DP, Buchbinder EI, Mudigonda T, Spencer K, Bender C, Lee J, Kaufman HL, Menzies AM, Hassel JC, Mehnert JM, Sosman JA, Long GV, Clark JI (2016) Ipilimumab therapy in patients with advanced melanoma and preexisting autoimmune disorders. JAMA Oncol 2(2):234–240. https://doi.org/10.1001/jamaoncol.2015.4368
Kolb NA, Trevino CR, Waheed W, Sobhani F, Landry KK, Thomas AA, Hehir M (2018) Neuromuscular complications of immune checkpoint inhibitor therapy. Muscle Nerve. https://doi.org/10.1002/mus.26070
Makarious D, Horwood K, Coward JIG (2017) Myasthenia gravis: an emerging toxicity of immune checkpoint inhibitors. Eur J Cancer 82:128–136. https://doi.org/10.1016/j.ejca.2017.05.041
Perez-De-Lis M, Retamozo S, Flores-Chavez A, Kostov B, Perez-Alvarez R, Brito-Zeron P, Ramos-Casals M (2017) Autoimmune diseases induced by biological agents. A review of 12,731 cases (BIOGEAS registry). Expert Opin Drug Saf 16(11):1255–1271. https://doi.org/10.1080/14740338.2017.1372421
Wang HB, Shi FD, Li H, Chambers BJ, Link H, Ljunggren HG (2001) Anti-CTLA-4 antibody treatment triggers determinant spreading and enhances murine myasthenia gravis. J Immunol 166(10):6430–6436
Zhu J, Li Y (2016) Myasthenia gravis exacerbation associated with pembrolizumab. Muscle Nerve 54(3):506–507. https://doi.org/10.1002/mus.25055
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Rights and permissions
About this article
Cite this article
Derle, E., Benli, S. Ipilimumab treatment associated with myasthenic crises and unfavorable disease course. Neurol Sci 39, 1773–1774 (2018). https://doi.org/10.1007/s10072-018-3471-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10072-018-3471-6