21 Dec U Michigan Study Finds Biomarkers Can Predict Myocarditis from Immune Checkpoint Inhibitors
MedicalResearch.com Interview with:
Salim S. Hayek MD
Medical Director of the Frankel Cardiovascular Center Clinics
University of Michigan
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Essentially, immune checkpoint myocarditis is a rare but deadly complication of immune checkpoint inhibitors – amazing drugs that are increasingly used for the treatment of various cancers. Most patients present late, and when they do, they’re very ill and have a 50% chance of death.
Diagnosing ICI myocarditis is challenging, given there is no one test that can differentiate it from other causes of cardiac injury. It is important to diagnose it fast, early and accurately in order to start immunosuppressive therapy as soon as possible.
What we did in this study was look at commonly measured biomarkers in all patients receiving ICI at the University of Michigan.
What we found was that patients who developed ICI myocarditis had early signs of muscle destruction (rise in CPK) levels and hepatitis (rise in AST, ALT), and that all patients who had myocarditis with bad outcomes had rises in all of the aforementioned biomarkers. Creatinine phosphokinase was the most sensitive.
MedicalResearch.com: What should readers take away from your report?
Response: What this means, is that we should now screen patients with suspected ICI myocarditis with CPK levels. If there is no increase in CPK levels, then the diagnosis is unlikely to be ICI myocarditis. We can also use this to monitor patients, and in those with rises in CPK levels, we can check troponin for myocardial injury, then initiate treatment early – before they develop severe cardiac decompensation.
MedicalResearch.com: What recommendations do you have for future research as a results of this study?
Response: This study provides guidance on screening for ICI myocarditis. We now look forward to studies determining what is the best treatment approach for these patients.
No disclosures for this study.
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