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Periodontitis is an immune-related adverse event associated with immune checkpoint inhibitors: A multi-center cohort study.
Ma, Kevin Sheng-Kai; Chiang, Cho-Hung; Chen, Steven T; Dinh, Yen; Chiang, Cho-Hsien; Van Dyke, Thomas E; Sullivan, Ryan; Ananthakrishnan, Ashwin N; Hsia, Yuan Ping; Peng, Cheng-Ming; Chiang, Cho-Han.
Afiliação
  • Ma KS; Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
  • Chiang CH; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
  • Chen ST; Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Dinh Y; Harvard School of Dental Medicine, Boston, MA, USA.
  • Chiang CH; Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan; London School of Hygiene & Tropical Medicine, London, UK.
  • Van Dyke TE; Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, USA; Center for Clinical and Translational Research, ADA Forsyth Institute, Cambridge, MA, USA.
  • Sullivan R; Division of Medical Oncology, Massachusetts General Hospital, Boston, MA, USA.
  • Ananthakrishnan AN; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Hsia YP; Department of Family Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan. Electronic address: ustwhealth.datascience.group@gmail.com.
  • Peng CM; School of Medicine, Chung Shan Medical University, Taichung, Taiwan; Da Vinci Minimally Invasive Surgery Center, Chung Shan Medical University Hospital, Taichung, Taiwan. Electronic address: jimy5989@gmail.com.
  • Chiang CH; Department of Medicine, Mount Auburn Hospital, Harvard Medical School, Cambridge, MA, USA.
Cancer Lett ; 598: 217100, 2024 Aug 28.
Article em En | MEDLINE | ID: mdl-38969158
ABSTRACT
Immune checkpoint inhibitors (ICIs) cause immune-related adverse events (irAEs) across various organ systems including oral health complications such as dry mouth and stomatitis. In this study, we aimed to determine the risk of periodontitis among patients on immune checkpoint inhibitors (ICIs) and to test the associations between ICI-associated periodontitis and other immune-related adverse events (irAEs). We performed a retrospective cohort study involving adult cancer patients between January 2010 and November 2021. Patients on an ICI were propensity score-matched to patients not on an ICI. The primary outcome was the occurrence of periodontitis. ICIs included programmed cell death 1 (PD-1) inhibitors programmed cell death ligand 1 (PD-L1) inhibitors, and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) inhibitors. The risk of periodontitis following ICI use was derived through a Cox proportional hazard model and Kaplan-Meier survival analysis. Overall, 868 patients on an ICI were matched to patients not on an ICI. Among the ICI cohort, 41 (4.7 %) patients developed periodontitis. The incidence rate of periodontitis was significantly higher in patients on an ICI than in patients not on an ICI (55.3 vs 25.8 per 100 patient-years, incidence rate ratio = 2.14, 95 % CI = 1.38-3.33). Both the use of PD-L1 inhibitors (multivariate HR = 2.5, 95%CI = 1.3-4.7) and PD-1 inhibitors (multivariate HR = 2.0, 95%CI = 1.2-3.2) were associated with the risk of periodontitis. The presence of immune-related periodontitis was associated with better overall survival (not reached vs 17 months, log-rank p-value<0.001), progression-free survival (14.9 vs 5.6 months, log-rank p-value = 0.01), and other concomitant immune-related cutaneous adverse events. In conclusion, ICI was associated with an increased risk of periodontitis. Immune-related periodontitis as an irAE was associated with better cancer survival and concomitant cutaneous irAEs.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Periodontite / Inibidores de Checkpoint Imunológico / Neoplasias Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Periodontite / Inibidores de Checkpoint Imunológico / Neoplasias Idioma: En Ano de publicação: 2024 Tipo de documento: Article