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

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

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  
  1. 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
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