|
Case series/report(s) | Number of patients | Immune-checkpoint inhibitor | Primary malignancy | Pattern | Joint involvement | Symmetrical/Asymmetrical | Axial/appendicular | Clinical diagnosis | Serology | Therapy | Steroid dose (for arthritis patients only) | Response | ICI status |
|
Chan et al. [17] | 2 | Anti-PD1: 2 | Melanoma: 2 | Seronegative arthritis: 2 | Polyarthritis: 2 | NA | None | Inflammatory arthritis | RF: −ve, anti-CCP: −ve, ANA: −ve | Opioid analgesics: 1, pamidronate, NSAIDs and DMARDs (sulfasalazine, HCQ): 1 | Steroid not used | Improvement: 2 | Continued: 1, held: 1 |
Law-Ping-Man et al. [22] | 1 | Anti-PD1 | NSCLC | Psoriatic arthritis | Oligoarthritis | Asymmetrical | None | Inflammatory arthritis | RF: −ve, anti-CCP: −ve, ANA: −ve | Steroid, DMARDs (MTX) | Prednisone (15 mg/day) | Improvement | Continued |
Ruiz-Bañobre et al. [23] | 1 | Anti-PD1 | NSCLC | Psoriatic arthritis | Polyarthritis | NA | NR | Inflammatory arthritis | RF: −ve, anti-CCP: −ve, ANA: −ve | IA steroid, steroid, NSAIDs, DMARDS (MTX, sulfasalazine) | Methylprednisone (4 mg/day) | Improvement | Continued |
Kim et al. [24] | 3 | Anti-PD1: 1, anti-PD1 and anti-CTLA-4: 2 | Melanoma: 3 | Seronegative arthritis: 3 | Polyarthritis: 3 | Symmetrical: 3 | None | Arthritis | RF: −ve, anti-CCP Ab: −ve, ANA: 1 | Prednisone and anti-IL-6 Ab: 2, anti-IL-6 Ab (tocilizumab): 1 | Prednisone (40 mg/day) | Improvement: 3 | NR |
Kuswanto et al. [19] | 4 | Anti-PD1: 4 | RCC: 4 | Seronegative arthritis: 3, PMR: 1 | Polyarthritis: 3 | Symmetrical: 2 | Pelvic girdle: 1 | Inflammatory arthritis | RF: NA, anti-CCP Ab: NA, ANA: NA | Steroid: 1, steroid and IA steroid: 1, steroid and DMARDs (MTX): 1, infliximab: 1 | Prednisone (50–20 mg/day) | Improvement: 4 | Held: 3 |
Cappelli et al. [25] | 9 | Anti-PD1: 2, anti-PD1 and anti-CTLA-4: 7 | RCC: 1, small cell lung cancer: 1, melanoma: 3, NSCLC: 4 | Seronegative arthritis: 9 | Polyarthritis: 8, oligoarthritis: 1 | NR | Back pain: 1 | Inflammatory arthritis | RF: −ve, anti-CCP Ab: −ve, ANA: 1 | Prednisone: 1, dexamethasone: 1, NSAIDs and IA steroid: 1, prednisone and TNF alfa inhibitor: 2, prednisone, DMARDs (MTX, infliximab, etanercept) and IA steroid: 2, prednisone and IA steroid: 2 | Prednisone (40–10 mg/day), 120 mg for 1 patient | Improvement: 7, partial response: 1, NR: 1 | NR |
Calabrese et al. [20] | 10 | Anti-PD1: 1, anti-PD1 and anti-CTLA-4: 6 | NSCLC: 1, RCC: 2, melanoma: 4 | Seronegative arthritis: 7, PMR: 3 | Polyarthritis: 7 | Symmetrical: 6, asymmetrical: 1 | None | Arthritis | RF: 1, anti-CCP Ab: −ve, ANA: 1 | Prednisone: 6, prednisone and DMARDs (HCQ, MTX, infliximab, etanercept, adalimumab): 4 | Prednisone (40–15 mg/day) | Significant improvement: 4, moderate improvement: 4, minimal improvement: 2 | Held: 4, continued: 3 |
Belkhir et al. [26] | 10 | Anti-PD1/PD-L1: 9, anti-PD1 and anti-CTLA-4: 1 | Melanoma: 3, lung adenocarcinoma: 2, endometrial adenocarcinoma: 1, squamous cell carcinoma of the vagina: 1, mesothelioma: 1, colon adenocarcinoma: 1, gastric adenocarcinoma: 1 | RA: 6, PMR: 4 | NR | NR | NR | Inflammatory arthritis | RF: 4, anti-CCP Ab: 6, ANA: 1 | Steroid: 7, NSAIDs: 1, NSAIDs and DMARDs (MTX, HCQ): 2 | Prednisone (20–10 mg/day) 60 mg for 1 patient | Improvement: 10 | Continued: 9 |
Le Burel et al. [27] | 17 | Anti-PD1/PD-L1: 15, anti-PD1 and anti-CTLA-4: 2 | Melanoma: 3, RCC: 2, lung adenocarcinoma: 3, pleural mesothelioma: 1, endometrioid carcinoma: 1, colon adenocarcinoma: 1, vaginal squamous cell carcinoma: 1, lung squamous carcinoma: 1, urothelial bladder cancer: 1, glioblastoma: 1, renal epithelioid angiomyolipoma: 1, gastric adenocarcinoma: 1 | RA: 3, PMR: 4, psoriatic arthritis: 3, seronegative arthritis: 7 | Polyarthritis: 13 | Symmetrical: 11, asymmetrical: 1 | NR | Inflammatory arthritis | RF: 3, anti-CCP Ab: 3, ANA: 1 | Steroids: 14, steroid and DMARDs (MTX): 2 | NA | Improvement: 9, resolution: 7, stable: 1 | NA |
Le Bakhaya et al. [28] | 26 | Anti-PD1: 23, anti-PD1 and anti-CTLA-4: 3 | Melanoma: 25, Merkel cell carcinoma: 1 | Arthritis: 10, activated osteoarthritis: 5, arthralgia (not specified): 11 | Polyarthritis: 7, oligoarthritis: 19 | Symmetrical: 16 | NR | Arthralgia | RF: 2, anti-CCP ab: 1, ANA: 1 | NSAIDs: 19, steroid: 5, DMARDs (sulfasalazine, HCQ): 2 | Prednisone (5–10 mg/day) | Complete response: 4, partial response: 15, stable disease: 5 | Held: 2 |
Ngo et al. [29] | 1 | Anti-PD1 | Melanoma | Seronegative arthritis | Polyarthritis | Symmetrical | None | Inflammatory arthritis | RF: −ve, anti-CCP: −ve, ANA: −ve | Steroid | Prednisone (40 mg/day) | Improvement | Continued |
Haikal et al. [21] | 1 | Anti-PD1 | Melanoma | Seronegative arthritis | Polyarthritis | Symmetrical | None | Arthritis | RF: −ve, anti-CCP: −ve | Steroid and DMARDs (HCQ) | Low-dose steroid | Improvement | NR |
Inamo et al. [18] | 3 | Anti-PD1: 3 | Lung adenocarcinoma: 1, lung squamous cell carcinoma: 1, ovarian cancer: 1 | Seronegative arthritis: 3 | Polyarthritis: 2, oligoarthritis: 1 | Symmetrical: 3 | None | Inflammatory arthritis | RF: −ve, Anti-CCP Ab: −ve, ANA: −ve | NSAIDs: 1, opioid: 1, NSAIDs and prednisone: 1 | Prednisone (20 mg/day) for 1 patient only | Improvement: 3 | NR |
Smith and Bass [30] | 10 | Anti- PD1: 3, anti-PD-1 and anti-CTLA-4: 7 | Melanoma: 4, lung adenocarcinoma: 2, RCC: 1, Merkel: 1, anal cancer: 1, cervical cancer: 1 | RA: 3, PMR: 1, others: 6 | Polyarthritis: 4, oligoarthritis: 4, tenosynovitis: 2 | NA | NA | Inflammatory arthritis | RF: NA, anti- CCP Ab: 2, ANA: 6 | Steroid: 6, steroid and DMARDs (HCQ, sulfasalazine, MTX, mycophenolate mofetil): 4 | Prednisone (20–10 mg/day) | Improvement: 4, resolution: 6 | Held: 1 |
Lidar et al. [31] | 12 | Anti-PD1: 8, anti-CTLA 4: 1, anti-PD1 and anti-CTLA-4: 3 | Melanoma: 10, sinonasal carcinoma: 1, endometrial carcinoma: 1 | Seronegative arthritis: 12 | Polyarthritis: 10, oligoarthritis: 1, monoarthritis: 1 | NR | None | Inflammatory arthritis | RF: −ve, anti-CCP Ab: none, ANA: −ve | NSAIDs, steroid: 5, steroid and MTX: 2, NSAIDs, steroid, MTX: 5 | Prednisone (>20 mg/day) | Improvement: 11, unknown: 1 | Held: 3, continued: 3, off therapy: 6 |
Kostine et al. [32] | 35 | Anti-PD1/PD-L1: 33, anti-CTLA-4: 1, anti-PD-L1 and anti-CTLA- 4: 1 | Melanoma: 16, lung cancer: 12, RCC: 6, Merkel cell carcinoma: 1 | RA: 7, PMR: 11, psoriatic arthritis: 2, others: 15 | Mostly polyarthritis: exact no. not reported | Mostly symmetrical | Back pain: 10 | Inflammatory and noninflammatory arthritis | RF: −ve, anti-CCP Ab: 1, ANA: 4 | Steroid: 18, NSAIDs: 5, steroid and DMARDs (MTX): 2, intraarticular steroid: 1 | Prednisone (mean dose 15 mg) | Improvement: 35 | Continued: 34 |
Leipe et al. [33] | 14 | Anti-PD1: 10, anti-PD1 and anti-CTLA4: 4 | Melanoma: 10, NSCLC: 5 | Arthritis: 14, PMR: 5, Sicca syndrome: 2, myositis: 1 | Polyarthritis: 2, oligoarthritis: 5, monoarthritis: 7 | NR | NA | New-onset arthralgia and arthritis | RF: 5, anti-CCP: 1, ANA: 9 | Steroid: 3, steroid and DMRDs (MTX): 6, NSAIDs: 2, IA steroid: 8 | NR | Improvement: 13 | Continued: 14 |
Narváez et al. [34] | 11 | Anti-PD1/PD-L1: 10, anti-PD1 and anti-CTLA4: 1 | Lymphoma: 2, lung cancer: 4, RCC: 1, epithelioid mesothelioma: 1, pancreatic neuroendocrine cancer: 1, melanoma: 1, urothelial carcinoma: 1 | Seronegative arthritis: 5, PMR: 1, Sicca syndrome: 2, inflammatory myositis with fasciitis: 2, paraneoplastic acral vascular syndrome: 1 | Polyarthritis: 4, oligoarthritis: 1 | Mostly symmetrical | None | Arthritis | RF: −ve, anti-CCP: −ve, ANA: −ve | Steroid: 4, NSAIDs: 1, steroid and DMARDs (HCQ): 3 | Prednisone (cobra light schedule): 2 patients, prednisone 60 mg daily for 1 patient and methylprednisone 20 mg daily for 1 patient | Improvement: 10 | Continued: 6 |
|