Various Neurological Complications Tied to Anti-PD-1 Therapy

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The researchers found that 2.9% of the 347 patients treated with anti-PD-1 monoclonal antibodies developed subacute onset of neurological complications.
The researchers found that 2.9% of the 347 patients treated with anti-PD-1 monoclonal antibodies developed subacute onset of neurological complications.

(HealthDay News) — Neurological complications associated with anti-programmed death 1 (PD-1) antibody treatment have a diverse phenotype, according to a study published online in JAMA Neurology.

Justin C. Kao, MBChB, from the Mayo Clinic in Rochester, Minnesota, and colleagues conducted a retrospective cohort study involving patients with development of neurological symptoms within 12 months of receiving anti-PD-1 therapy.

The researchers found that 2.9% of the 347 patients treated with anti-PD-1 monoclonal antibodies developed subacute onset of neurological complications. Seven of these patients received pembrolizumab and 3 nivolumab. Neurological complications occurred after a median of 5.5 anti-PD-1 inhibitor cycles. Myopathy, varied neuropathies, cerebellar ataxia, autoimmune retinopathy, bilateral internuclear ophthalmoplegia, and headache were reported complications. Reported peripheral neuropathies were axonal and demyelinating polyradiculoneuropathies, length-dependent neuropathies, and asymmetric vasculitic neuropathy.

"Neurological adverse events associated with anti-PD-1 therapy have a diverse phenotype, with more frequent neuromuscular complications," the authors write. "Prompt recognition and discontinuation of anti-PD-1 therapy is recommended. In some cases, immune rescue treatment may be required."

One author disclosed financial ties to the pharmaceutical industry.

Reference

  1. Kao JC, Liao B, Markovic SN, et al. Neurological Complications Associated With Anti-Programmed Death 1 (PD-1) Antibodies. JAMA Neurol. 2017 Sep 5. doi: 10.1001/jamaneurol.2017.1912

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