Evidence map›Paper›PMID 36593626›Full record

ArticleBMJ case reports2022

Myasthenia gravis, myositis and myocarditis: a fatal triad of immune-related adverse effect of immune checkpoint inhibitor treatment.

Biji Soman, Maria Cecilia Dias, Syed Azhar J Rizvi, Attila Kardos

Open access · greenAbstract readCase Reports
In one paragraph

Article in BMJ case reports, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.5field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 15 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Biji SomanDepartment of Cardiology, Milton Keynes University Hospital, Milton Keynes, UK.ORCID http://orcid.org/0000-0002-8084-7193
Maria Cecilia DiasDepartment of Oncology, Milton Keynes University Hospital, Milton Keynes, UK.
Syed Azhar J RizviDepartment of Oncology, Milton Keynes University Hospital, Milton Keynes, UK.
Attila KardosDepartment of Cardiology, Milton Keynes University Hospital, Milton Keynes, UK attila.kardos@cardiov.ox.ac.uk.ORCID http://orcid.org/0000-0002-0231-7605
Milton Keynes Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Pembrolizumab, a humanised monoclonal antibody and immune checkpoint inhibitor (ICI) that blocks programmed death receptor 1 and its ligands, is an effective immunotherapy for malignancies such as melanoma, lung, head and neck, cancers, and Hodgkin's lymphoma. It has an overall response rate between 73% and 83%, with complete response rate of 27%-30%. It is well tolerated with minor side effects in 70% of cases characterised by fatigue, rash, pruritus and diarrhoea. In rare cases, more serious and life-threatening complications can occur at a rate of 0.3%-1.3%. We report a case of a woman in her 70s with non-small-cell lung cancer treated with ICI. She presented to the emergency department with left-sided ptosis and muscle weakness 3 weeks of her first dose of pembrolizumab infusion as a treatment plan of her cancer. She was diagnosed with myasthenia gravis, myocarditis and myositis as ICI-induced immune-related adverse effects resistant to medical intervention. We wish to raise awareness of the triad of life-threatening complication of ICI therapy that accounts for 30%-50% of fatal complications.

Indexed as

Antineoplastic Agents, ImmunologicalCarcinoma, Non-Small-Cell LungDrug-Related Side Effects and Adverse ReactionsLung NeoplasmsMyasthenia GravisMyocarditisMyositisFemaleHumansImmune Checkpoint InhibitorsAntineoplastic Agents, ImmunologicalImmune Checkpoint InhibitorsCancer interventionCancer - see OncologyCardiovascular systemLung cancer (oncology)Malignant disease and immunosuppression

Identifiers

PMID36593626
PMCPMC9743272
OpenAlexW4310856908

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.