Analysis of cases of immune myocarditis induced by camrelizumab

XUE Yan-mei; WANG Yan; YANG Na-min; QIAO Yi; WANG Jing-wen

doi:10.3969/j.issn.1672-8157.2023.06.020

Abstract：Objective:To analyze the adverse reactions and clinical characteristics of immune myocarditis induced by camrelizumab,and provide reference for clinical safe drug use.Methods:Search PubMed,Web of Science,Embase,Wanfang,CNKI,Vip and other databases(the search time was from the establishment of the database to December 2022)to collect case reports of Camrlizumab related immune myocarditis and conduct descriptive analysis on the patient's gender,age,medication,time of occurrence of immune myocarditis,clinical manifestations,etc.Results:A total of 16 patients with camrelizumab related immune myocarditis were collected,including 10 males(62.5%)and 6 females(37.5%).Among all patients,the youngest was 45 years old,the oldest was 76 years old,and the median age was 69 years old.The time from the exposure of Camrelizumab to the occurrence of immune myocarditis was 1-22 days,most of which occurred in 2-22 days(12 cases).One patient had no clinical symptoms,while the remaining 15 patients presented with clinical symptoms,including chest tightness,chest pain,shortness of breath,dyspnea,palpitation,fatigue and tachycardia in 14 cases.Among them,there were 3 cases of skeletal muscle involvement,2 cases of ophthalmic muscle involvement,1 case of ophthalmic muscle combined with skeletal muscle involvement,and 1 case of fever with fatigue and hypotension.When patients were diagnoised with myocarditis,four cases stopped using Camrelizumab.All 16 patients underwent high-dose hormone pulse therapy,with 8 patients receiving a combination of diuretics and cardiac stimulants,and 3 patients receiving a combination of immunostimulants.After treatment,13 patients improved,1 showed no significant change,1 aggravated,and 1 died.Conclusion:Immune myocarditis induced by Camrelizumab occurred 2 to 22 days after drug administration,mostly in male patients.The main clinical manifestations were chest tightness and shortness of breath,dyspnea,fatigue,tachycardia,and mostly involved myocardium,skeletal muscle,and eye muscle.The severity of the symptoms was different,and the prognosis after treatment was not very good.