TY - JOUR T1 - Risk of irAEs in patients with autoimmune diseases treated by immune checkpoint inhibitors for stage III or IV melanoma: results from a matched case–control study JF - Annals of the Rheumatic Diseases JO - Ann Rheum Dis SP - 1445 LP - 1452 DO - 10.1136/ard-2022-222186 VL - 81 IS - 10 AU - Léo Plaçais AU - Stéphane Dalle AU - Olivier Dereure AU - Sabiha Trabelsi AU - Sophie Dalac AU - Delphine Legoupil AU - Henri Montaudié AU - Jean-Philippe Arnault AU - Julie De Quatrebarbes AU - Philippe Saiag AU - Florence Brunet-Possenti AU - Thierry Lesimple AU - Eve Maubec AU - François Aubin AU - Florence Granel-Brocard AU - Jean-Jacques Grob AU - Pierre-Emmanuel Stoebner AU - Clara Allayous AU - Bastien Oriano AU - Caroline Dutriaux AU - Laurent Mortier AU - Céleste Lebbe Y1 - 2022/10/01 UR - http://ard.bmj.com/content/81/10/1445.abstract N2 - Objective To quantify the risk of immune-related adverse events (irAEs) in patients with pre-existing autoimmune disease (pAID) treated by immune checkpoint inhibitors (ICIs) for stage III or IV melanoma.Methods Case–control study performed on a French multicentric prospective cohort of patients with melanoma, matched for irAE risk factors and oncological staging. Risk of irAE was assessed by logistic regression.Results 110 patients with pAID were included and matched with 330 controls, from March 2013 to October 2020. Over a median follow-up period of 7.2 months for cases and 6.9 months for controls, the ORs of developing all-grade and grade ≥3 irAEs among cases compared with controls were 1.91 (95% CI (1.56 to 2.27)) and 1.44 (95% CI (1.08 to 1.82)), respectively. Patients with pAID had an increased risk of multiple irAEs (OR 1.46, 95% CI (1.15 to 2.67)) and a shorter time to irAE onset. In contrast, there were no difference in irAE-related mortality nor in the rate of treatment discontinuation, and a landmark analysis revealed a better survival at 24 months among cases (p=0.02). Thirty per cent of cases experienced a pAID flare during follow-up, and baseline immunosuppression did not prevent irAE occurrence. Last, we report associations between the pAID clinical subsets and organ-specific irAEs.Conclusion In our study, patients with pAID were at greater risk of all-grade, severe and multiple irAEs, yet had a better 24-month survival than controls. Thus, patients with pAID should be eligible for ICI therapy but benefit from a close monitoring for irAE occurrence, especially during the first months of therapy.Data will be available on request and acceptance of the MelBase cohort scientific board. ER -