medwireNews: Certain patient groups generally considered at low risk for developing myocarditis may need careful monitoring if they are taking immune checkpoint inhibitors for cancer, say researchers.
In particular, women and individuals aged 75 years or older were significantly more likely to experience myocarditis if they were receiving immunotherapy, with odds ratios (ORs) of 1.92 and 7.61 versus men and younger patients, respectively.
Such an association was not observed in the absence of checkpoint blockade, and in fact, female sex and older age were associated with a significantly lower myocarditis risk (ORs=0.44 and 0.19, respectively).
The study authors caution, however, that there could be an imbalance of risk factors between groups, such as the incidence of autoimmune disease, which may explain the elevated risk.
They add that the effects of sex differences on immune-related adverse events “remain controversial, and therefore further specific studies of this association are needed.”
For this study, which appears in JAMA Oncology, Yoshito Zamami (Tokushima University Graduate School of Biomedical Sciences, Japan) and co-investigators analyzed 1,979,157 reports from the US FDA Adverse Event Reporting System database, of which 13,096 were reports from individuals treated with the anti-PD-1 or anti-PD-L1 agents atezolizumab, durvalumab, ipilimumab, nivolumab, or pembrolizumab.
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