Immune checkpoint inhibitor-induced inflammatory arthritis persists after immunotherapy cessation
Open accessAbstract
Objective We sought to investigate the long-term outcomes of patients who develop immune checkpoint inhibitor (ICI)-induced inflammatory arthritis (IA), to define factors associated with IA persistence after ICI cessation, the need for immunosuppressants and the impact of these medications on underlying malignancies.Methods We conducted a prospective observational study of patients referred for IA associated with ICIs. Patients were recruited from June 2015 to December 2018. Information was obtained at the baseline visit, and follow-up visits occurred at varying intervals for up to 24 months from ICI cessation. Kaplan-Meier curves were developed to characterise IA persistence. Cox proportional hazards models were used to assess the influence of various factors on IA persistence. Logistic regression was used to evaluate the impact of IA treatment on tumour response.Results Sixty patients were monitored with a median follow-up after ICI cessation of 9 months. A majority (53.3%) had active IA at their most recent follow-up. IA was less likely to improve in those with longer duration of ICI use, in those receiving combination ICI therapy, and in patients with multiple other immune-related adverse events. Tumour response did not appear to be impacted by immunosuppression. Although not statistically significant, persistent IA was correlated with a better tumour response (complete or partial response).Conclusion ICI-induced IA can become a long-term disease necessitating management by rheumatology for immunomodulatory treatment. Importantly, the use of immunomodulatory treatment has not been shown to impact cancer outcomes in this study.
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Patients with pre-existing autoimmune disease may have somewhat higher risk of irAEs, usually low-grade flares of their pre-existing disease rather than de novo events.
“Patients with pre-existing autoimmune disease may have somewhat higher risk of irAEs, although these usually relate to increased risks of low-grade flares of their pre-existing disease rather than de novo events.30–32”
From Endocrine toxicities of immune checkpoint inhibitors (2021) · cites this paper as [30]
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- Authors
- Braaten, T. J., Brahmer, J. R., Forde, P. M., Le, D., Lipson, E. J., Naidoo, J., Schollenberger, M., Zheng, L., Bingham, C. O., Shah, A. A., & Cappelli, L. C.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- Cappelli, Laura C
- ORCID
- Venue
- Annals of the Rheumatic Diseases
- Publisher
- Elsevier BV
- Published
- 2020-03
- Volume
- 79
- Issue
- 3
- Pages
- 332-338
- ISSN
- 0003-4967 (ISSN-L)
- PMC
- PMC7031780
- OpenAlex
- W2974173963
- Cited by
- 230
- References
- 32
- Citations by year
- 2026: 24 · 2025: 31 · 2024: 32 · 2023: 26 · 2022: 36 · 2021: 35 · 2020: 41 · 2019: 3 · 2018: 1
- FWCI
- 12.02
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Annals of the Rheumatic Diseases (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- The Passano Foundation
- National Cancer Institute (P30-AR070354)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (P30-AR070354, R01AR073208, T32-AR048522)
- Bloomberg Kimmel Institute for Cancer Immunotherapy
- Barney Family Foundation
- Jerome L. Greene Foundation (Scholar Award)
- Moving for Melanoma of Delaware
- AbbVie
- The Laverna Hahn Charitable Trust
- Bristol-Myers Squibb
- Topics
- Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
- Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
- Health Sciences › Medicine › Epidemiology › Inflammatory Myopathies and Dermatomyositis
- Keywords
- immune checkpoint inhibitors, immune-related adverse events, long-term outcomes, immunosuppressive therapy, tumor response, combination immunotherapy
- MeSH terms
- Antineoplastic Agents, Immunological, Aged, Arthritis, Female, Humans, Immunologic Factors, Immunotherapy, Male, Middle Aged, Neoplasms, Prospective Studies, Logistic Models, Proportional Hazards Models, Kaplan-Meier Estimate
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