Uveitis in Patients Treated with CTLA-4 and PD-1 Checkpoint Blockade Inhibition

Michel M. Sun*, Ralph D. Levinson, Artur Filipowicz, Stephen Anesi, Henry J. Kaplan, Wei Wang, Debra A. Goldstein, Sapna Gangaputra, Robert T. Swan, H. Nida Sen, Lynn K. Gordon

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Purpose: To investigate the link between treatment with CTLA-4 and PD-1 checkpoint blockade inhibitors and the development of noninfectious uveitis. Methods: A survey was distributed to uveitis specialists to identify patients who developed uveitis while receiving either PD-1 inhibitors pembrolizumab and nivolumab; PD-L1 inhibitors atezolizumab, avelumab, and durvalumab; or the CTLA-4 inhibitor ipilimumab. Results: Fifteen patients from seven institutions were identified. The most common cancer diagnosis (13/15) was malignant melanoma. Fourteen patients had a new uveitis diagnosis following checkpoint blockade administration (six anterior uveitis, six panuveitis, one posterior uveitis, one anterior/intermediate combined); one patient developed optic neuritis. Uveitis was diagnosed within 6 months after drug initiation for 11/12 patients (median 63 days). Corticosteroid treatment was effective for most patients, although two patients had permanent loss of vision. Conclusions: Patients on checkpoint inhibitor therapy should be educated to seek care if they develop ocular symptoms, and prompt referral to specialists should be incorporated into oncology protocols.

Original languageEnglish (US)
Pages (from-to)217-227
Number of pages11
JournalOcular Immunology and Inflammation
Volume28
Issue number2
DOIs
StatePublished - Feb 17 2020

Keywords

  • CTLA-4
  • Checkpoint inhibitor
  • PD-1
  • immunotherapy
  • ocular inflammation
  • uveitis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Ophthalmology

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