Does inflammaging worsen Rh-irAEs after ICI treatment?

Inflammaging plays no significant role in rheumatic immune-related adverse events (Rh-irAEs), as shown by the comparable numbers of overall irAEs and the severity of RH-irAEs between older and younger patients who developed these conditions after treatment with immune checkpoint inhibitors (ICIs), a study has shown. 

A group of researchers prospectively followed 139 adults with new Rh-irAEs after ICI exposure across 10 Canadian sites as part of the Canadian Research Group of Rheumatology in Immuno-Oncology (CanRIO) prospective cohort. Participants were seen between January 2020 and March 2023. 

The research team then compared the severity and the number of Rh-irAEs between patients aged ≥65 years and <65 years, as well as explored the potential epidemiologic, treatment-related, and phenotypic differences between the older and younger patients. 

Of the participants with de novo Rh-irAEs, 58 were included in the younger age group and 81 in the older age group. No significant differences were noted in the severity (p=0.84) or the number of Rh-irAEs (p=0.21), but a nonsignificant trend was observed toward more younger than older patients with three or more irAEs (24 percent vs 14 percent). 

The types of treatment for Rh-irAEs and ICI continuation did not significantly differ between the two groups. Within the ICI-related inflammatory arthritis subgroup, no significant differences were also noted in the incidence of severe Rh-irAEs (p=0.51). 

“Larger studies are needed to explore potential differences in patient phenotypes,” the researchers said. 

"Ageing is associated with increased inflammation, referred to as ‘inflammaging’,” they noted.