Abatacept/Ruxolitinib and Screening for Concomitant Respiratory Muscle Failure to Mitigate Fatality of Immune-Checkpoint Inhibitor Myocarditis

Immune-checkpoint-inhibitor (ICI)-associated myotoxicity involves the heart (myocarditis) and skeletal muscles (myositis), which frequently occur concurrently and are highly fatal. We report the results of a strategy that included identification of individuals with severe ICI myocarditis by also screening for and managing concomitant respiratory muscle involvement with mechanical ventilation, as well as treatment with the CTLA4 fusion protein abatacept and the JAK inhibitor ruxolitinib. Forty cases with definite ICI myocarditis were included with pathologic confirmation of concomitant myositis in the majority of patients. In the first 10 patients, using recommended guidelines, myotoxicity-related fatality…

• A
  Amgen
• A
  AstraZeneca
• S
  Sanofi
• TP
  Teva Pharmaceutical Industries
• C
  Celgene
• VU
  Vanderbilt University
• VU
  Vanderbilt University Medical Center
• B
  BeiGene
• E
  Eisai
• AP
  Astellas Pharma
• NI
  National Institutes of Health

  Awards: R01HL155990, R01HL156021, R01HL141466