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Characteristics and treatment of new-onset arthritis after checkpoint inhibitor therapy

Immune checkpoint inhibitors (ICIs) may cause immune-related adverse events (IRAEs). Characterisation and data on treatment of musculoskeletal IRAEs are scarce. In this cohort study, patients receiving ICI therapy who experienced arthralgia were evaluated for the presence of synovitis. Data on demog...

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Autores principales: Leipe, Jan, Christ, Lisa A, Arnoldi, Andreas P, Mille, Erik, Berger, Frank, Heppt, Markus, Goldscheider, Ilana, Kauffmann-Guerrero, Diego, Huber, Rudolf M, Dechant, Claudia, Berking, Carola, Schulze-Koops, Hendrik, Skapenko, Alla
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6109812/
https://www.ncbi.nlm.nih.gov/pubmed/30167328
http://dx.doi.org/10.1136/rmdopen-2018-000714
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author Leipe, Jan
Christ, Lisa A
Arnoldi, Andreas P
Mille, Erik
Berger, Frank
Heppt, Markus
Goldscheider, Ilana
Kauffmann-Guerrero, Diego
Huber, Rudolf M
Dechant, Claudia
Berking, Carola
Schulze-Koops, Hendrik
Skapenko, Alla
author_facet Leipe, Jan
Christ, Lisa A
Arnoldi, Andreas P
Mille, Erik
Berger, Frank
Heppt, Markus
Goldscheider, Ilana
Kauffmann-Guerrero, Diego
Huber, Rudolf M
Dechant, Claudia
Berking, Carola
Schulze-Koops, Hendrik
Skapenko, Alla
author_sort Leipe, Jan
collection PubMed
description Immune checkpoint inhibitors (ICIs) may cause immune-related adverse events (IRAEs). Characterisation and data on treatment of musculoskeletal IRAEs are scarce. In this cohort study, patients receiving ICI therapy who experienced arthralgia were evaluated for the presence of synovitis. Data on demographics, ICI regime, time of onset, imaging and response to therapy of synovitis were prospectively collected. Arthritis was demonstrated in 14 of 16 patients of whom 7 showed monarthritis, 5 had oligoarthritis and 2 had polyarthritis. Patients with ICI-induced arthritis were predominantly male (57%) and seronegative (69%). Regarding the detection of synovitis in staging imaging, moderate sensitivity for contrast-enhanced CT with PET-CT as reference was observed. Disease burden at baseline was high and was significantly reduced after anti-inflammatory treatment. Nine patients were treated with systemic and eight patients with intra-articular glucocorticoids. Six patients who flared on glucocorticoid treatment on tapering were given methotrexate resulting in long-term remission. Patients with synovitis were more likely to have good tumour response. Patients with ICI-induced arthritis were predominantly male and seronegative showing different patterns of arthritis with high disease burden. Good efficacy and safety was observed for methotrexate, particularly for ICI-induced polyarthritis.
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spelling pubmed-61098122018-08-30 Characteristics and treatment of new-onset arthritis after checkpoint inhibitor therapy Leipe, Jan Christ, Lisa A Arnoldi, Andreas P Mille, Erik Berger, Frank Heppt, Markus Goldscheider, Ilana Kauffmann-Guerrero, Diego Huber, Rudolf M Dechant, Claudia Berking, Carola Schulze-Koops, Hendrik Skapenko, Alla RMD Open Autoimmunity Immune checkpoint inhibitors (ICIs) may cause immune-related adverse events (IRAEs). Characterisation and data on treatment of musculoskeletal IRAEs are scarce. In this cohort study, patients receiving ICI therapy who experienced arthralgia were evaluated for the presence of synovitis. Data on demographics, ICI regime, time of onset, imaging and response to therapy of synovitis were prospectively collected. Arthritis was demonstrated in 14 of 16 patients of whom 7 showed monarthritis, 5 had oligoarthritis and 2 had polyarthritis. Patients with ICI-induced arthritis were predominantly male (57%) and seronegative (69%). Regarding the detection of synovitis in staging imaging, moderate sensitivity for contrast-enhanced CT with PET-CT as reference was observed. Disease burden at baseline was high and was significantly reduced after anti-inflammatory treatment. Nine patients were treated with systemic and eight patients with intra-articular glucocorticoids. Six patients who flared on glucocorticoid treatment on tapering were given methotrexate resulting in long-term remission. Patients with synovitis were more likely to have good tumour response. Patients with ICI-induced arthritis were predominantly male and seronegative showing different patterns of arthritis with high disease burden. Good efficacy and safety was observed for methotrexate, particularly for ICI-induced polyarthritis. BMJ Publishing Group 2018-08-17 /pmc/articles/PMC6109812/ /pubmed/30167328 http://dx.doi.org/10.1136/rmdopen-2018-000714 Text en © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Autoimmunity
Leipe, Jan
Christ, Lisa A
Arnoldi, Andreas P
Mille, Erik
Berger, Frank
Heppt, Markus
Goldscheider, Ilana
Kauffmann-Guerrero, Diego
Huber, Rudolf M
Dechant, Claudia
Berking, Carola
Schulze-Koops, Hendrik
Skapenko, Alla
Characteristics and treatment of new-onset arthritis after checkpoint inhibitor therapy
title Characteristics and treatment of new-onset arthritis after checkpoint inhibitor therapy
title_full Characteristics and treatment of new-onset arthritis after checkpoint inhibitor therapy
title_fullStr Characteristics and treatment of new-onset arthritis after checkpoint inhibitor therapy
title_full_unstemmed Characteristics and treatment of new-onset arthritis after checkpoint inhibitor therapy
title_short Characteristics and treatment of new-onset arthritis after checkpoint inhibitor therapy
title_sort characteristics and treatment of new-onset arthritis after checkpoint inhibitor therapy
topic Autoimmunity
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6109812/
https://www.ncbi.nlm.nih.gov/pubmed/30167328
http://dx.doi.org/10.1136/rmdopen-2018-000714
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