ReviewDiagnostics (Basel, Switzerland)2024
Myocarditis, Myositis, and Myasthenia Gravis Overlap Syndrome Associated with Immune Checkpoint Inhibitors: A Systematic Review.
Review in Diagnostics (Basel, Switzerland), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 3 of them syntheses that pooled 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.
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.
Who cites it
42 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Triple-M syndrome after immune checkpoint inhibitors: a systematic review of cases-early recognition is critical to survival.Frontiers in neurology · 2026Pooled it
- Successful rescue therapy with eculizumab for probable tislelizumab-related MMM overlap syndrome with dual positivity for anti-acetylcholine receptor and anti-titin antibodies: a case report and literature review.Frontiers in immunology · 2026Pooled it
- Immune checkpoint inhibitor-related myositis, myocarditis, and myasthenia gravis overlap syndrome: a systematic review and pooled analysis of individual cases.Frontiers in immunology · 2026Pooled it
- Review
- Neurological Adverse Events Associated With Immune Checkpoint Inhibitors Identified Through Disproportionality Analysis of the FDA Adverse Event Reporting System.Cancer medicine · 2026Article
- Reversible complete atrioventricular block in immune checkpoint inhibitor-associated triple-M overlap syndrome: a case report.European heart journal. Case reports · 2026Article
- Single-Dose Nivolumab as a Trigger of Myocarditis, Myositis, and Myasthenia Gravis Overlap Syndrome With Late Cardiac Death Despite Initial Recovery: A Case Report.The American journal of case reports · 2026Article
- Immune checkpoint inhibitor-induced myasthenia gravis and myocarditis: a fatal immune-related adverse event.Immunologic research · 2026Article
- Article
- Triple M overlap syndrome in the intensive care unit: differential diagnosis and management.Critical care (London, England) · 2026Review
- Triple-M Overlap Syndrome Associated with Immune Checkpoint Inhibitors: A FAERS Pharmacovigilance Analysis.Healthcare (Basel, Switzerland) · 2026Article
- Successful Treatment of Immune Checkpoint Inhibitor-Induced Myocarditis, Myositis, and Myasthenia Overlap Syndrome With Baricitinib and Abatacept.Clinical case reports · 2026Article
- Article
- Article
- Immune checkpoint inhibition and heart injury: molecular mechanisms and clinical challenges.ESC heart failure · 2026Review
- Immune Checkpoint Inhibitor-Associated Myocarditis: Risk, Diagnosis, and Clinical Impact.Journal of clinical medicine · 2026Review
- Immune checkpoint inhibitor-related myositis with hepatitis in HER2-positive metastatic breast cancer after trastuzumab deruxtecan plus sintilimab: a case report.Frontiers in oncology · 2026Article
- Case report: Efgartigimod combined with intravenous methylprednisolone in a case of co-occurrence of unexplained myasthenia gravis, inflammatory myopathy, and fulminant myocarditis.Frontiers in immunology · 2026Article
- Clinical characteristics analysis of immune checkpoint inhibitors-related myocarditis.Frontiers in immunology · 2026Article
- Dynamic serum tumor-marker and immune-inflammatory biomarker changes for risk stratification of immune checkpoint inhibitor-associated myasthenia gravis in non-small cell lung cancer.Frontiers in immunology · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
Immune checkpoint inhibitors (ICIs) have significantly transformed cancer treatment, but their use is linked to immune-related adverse events (irAEs), including the rare ICI-associated myocarditis, myositis, and myasthenia gravis (MMM) overlap syndrome. This systematic review aims to highlight MMM's clinical implications in emergency departments. PubMed and Embase were searched using a specific search strategy. Reports were eligible for inclusion if all three conditions were present and associated with the use of an ICI. Data were extracted by independent reviewers using the Rayyan web application for systematic reviews. Descriptive statistics and qualitative synthesis were used to summarize demographic, clinical, and treatment data for the reported cases. Among 50 cases, predominantly associated with melanoma, lung cancer, and renal cancer, the in-hospital mortality rate was 38.0%. The most commonly presenting symptoms were ptosis (58%), dyspnea (48%), diplopia (42%), or myalgia (36%). The median time from ICI initiation to MMM presentation was 21 days (interquartile range: 15-28 days). Corticosteroids were the primary treatment for the irAEs. MMM, a rare but potentially fatal complication of ICI therapy, requires prompt recognition in emergency settings. Corticosteroids should be initiated if suspected, without waiting for confirmation. Multidisciplinary collaboration is vital for diagnosis and treatment planning. Research on MMM's link to specific cancers and ICIs is imperative for better risk assessment and interventions.
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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.