Progressive hypoventilation due to mixed CD8 + and CD4 + lymphocytic polymyositis following tremelimumab - durvalumab treatment

Table 1 Select cases of severe myositis associated with CTLA-4 and/or PD-1 axis inhibitors

Drug(s)	Description	↑CK?	ASM IgG?	Onset (wks)	Treatment	Trial	Reference
Ipilimumab + nivolumab	Polymyositis with respiratory involvement	Yes	Yes	3	Corticosteroid, infliximab, IVIG, Pex	NCT01928394	[35]
Nivolumab	Myositis with respiratory failure	Yes	–	7	Corticosteroid	–	[36]
Nivolumab	Myasthenia crisis and polymyositis requiring ventilation	Yes	No	2	Corticosteroid, Pex, IVIG pyridostigmine	–	[19]
Pembrolizumab	Polyarticular tenosynovitis and proximal myositis	No	–	56	Sulfasalazine	NCT01295827	[37]
Pembrolizumab	Exacerbation of preexisting myositis	Yes	–	1	IVIG	–	[38]
Ipilimumab	Dermatomyositis	Yes	–	2	Corticosteroid	–	[39]
Pembrolizumab / ipilimumab	Rhabdomyolysis associated with hypothyroidism	Yes	–	6	Levothyroxine	–	[40]
Ipilimumab	Combined myasthenia and myositis with AChR	Yes	Yes	7	Corticosteroid, IVIG	–	[26]
Ipilimumab	Retrobulbar weakness with proximal myositis.	Yes	Yes	7	Corticosteroid, IVIG	–	[3]
Ipilimumab	Orbital myositis associated with ipilimumab	–	–	12	Corticosteroid	–	[41]
Tremelimumab + durvalumab	Described in text.	No	Yes	4	Corticosteroid, Pex, IVIG	NCT02000947

Abbreviations: ASM, anti-striated muscle antibody, NCT national clinical trials identifier number, Pex plasma exchange, IVIG intravenous immunoglobulin G, AChR acetylcholine receptor antibody, CK creatine kinase, wks weeks