A Case of Severe Seronegative Inflammatory Arthritis due to Nivolumab and Review of the Literature
Identifieur interne : 000279 ( Pmc/Curation ); précédent : 000278; suivant : 000280A Case of Severe Seronegative Inflammatory Arthritis due to Nivolumab and Review of the Literature
Auteurs : Bicky Thapa [États-Unis] ; Asad Ali [États-Unis] ; Raunak Nair [États-Unis] ; Rishik Vashisht [États-Unis] ; Cassandra Calabrese [États-Unis]Source :
- Case Reports in Rheumatology [ 2090-6889 ] ; 2019.
Abstract
Immune-checkpoint inhibitors (ICIs) have revolutionized the treatment of cancer, yet therapy is often hampered by immune-related adverse events (irAEs) which range from mild to severe life-threatening events. Musculoskeletal (MSK) irAEs leading to discontinuation of ICIs are uncommon but increasingly recognized. We report a challenging case of severe immune-related seronegative inflammatory arthritis due to nivolumab in a patient with stage IV metastatic adenocarcinoma.
Url:
DOI: 10.1155/2019/1326734
PubMed: 31781462
PubMed Central: 6875374
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sortKey="Calabrese, Cassandra" sort="Calabrese, Cassandra" uniqKey="Calabrese C" first="Cassandra" last="Calabrese">Cassandra Calabrese</name><affiliation wicri:level="1"><nlm:aff id="I4">Department of Rheumatic & Immunologic Disease, Cleveland Clinic Foundation, Cleveland, Ohio, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Rheumatic & Immunologic Disease, Cleveland Clinic Foundation, Cleveland, Ohio</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">31781462</idno><idno type="pmc">6875374</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6875374</idno><idno type="RBID">PMC:6875374</idno><idno type="doi">10.1155/2019/1326734</idno><date when="2019">2019</date><idno type="wicri:Area/Pmc/Corpus">000279</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000279</idno><idno 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Foundation, Cleveland, Ohio, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Neurological Institute, Taussig Center Institute, Cleveland Clinic Foundation, Cleveland, Ohio</wicri:regionArea></affiliation></author><author><name sortKey="Nair, Raunak" sort="Nair, Raunak" uniqKey="Nair R" first="Raunak" last="Nair">Raunak Nair</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Internal Medicine, Cleveland Clinic Fairview Hospital, Cleveland, Ohio, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Internal Medicine, Cleveland Clinic Fairview Hospital, Cleveland, Ohio</wicri:regionArea></affiliation></author><author><name sortKey="Vashisht, Rishik" sort="Vashisht, Rishik" uniqKey="Vashisht R" first="Rishik" last="Vashisht">Rishik Vashisht</name><affiliation wicri:level="1"><nlm:aff id="I3">Respiratory Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA</nlm:aff><country 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Case Rep Rheumatol</journal-id><journal-id journal-id-type="iso-abbrev">Case Rep Rheumatol</journal-id><journal-id journal-id-type="publisher-id">CRIRH</journal-id><journal-title-group><journal-title>Case Reports in Rheumatology</journal-title></journal-title-group><issn pub-type="ppub">2090-6889</issn><issn pub-type="epub">2090-6897</issn><publisher><publisher-name>Hindawi</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">31781462</article-id><article-id pub-id-type="pmc">6875374</article-id><article-id pub-id-type="doi">10.1155/2019/1326734</article-id><article-categories><subj-group subj-group-type="heading"><subject>Case Report</subject></subj-group></article-categories><title-group><article-title>A Case of Severe Seronegative Inflammatory Arthritis due to Nivolumab and Review of the Literature</article-title></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="false">https://orcid.org/0000-0002-7636-8907</contrib-id><name><surname>Thapa</surname><given-names>Bicky</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Ali</surname><given-names>Asad</given-names></name><xref ref-type="aff" rid="I2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Nair</surname><given-names>Raunak</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Vashisht</surname><given-names>Rishik</given-names></name><xref ref-type="aff" rid="I3"><sup>3</sup></xref></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid" authenticated="false">https://orcid.org/0000-0002-8773-7739</contrib-id><name><surname>Calabrese</surname><given-names>Cassandra</given-names></name><email>calabrc@ccf.org</email><xref ref-type="aff" rid="I4"><sup>4</sup></xref></contrib></contrib-group><aff id="I1"><sup>1</sup>Department of Internal Medicine, Cleveland Clinic Fairview Hospital, Cleveland, Ohio, USA</aff><aff id="I2"><sup>2</sup>Neurological Institute, Taussig Center Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA</aff><aff id="I3"><sup>3</sup>Respiratory Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA</aff><aff id="I4"><sup>4</sup>Department of Rheumatic & Immunologic Disease, Cleveland Clinic Foundation, Cleveland, Ohio, USA</aff><author-notes><fn fn-type="other"><p>Academic Editor: Suleyman Serdar Koca</p></fn></author-notes><pub-date pub-type="collection"><year>2019</year></pub-date><pub-date pub-type="epub"><day>3</day><month>11</month><year>2019</year></pub-date><volume>2019</volume><elocation-id>1326734</elocation-id><history><date date-type="received"><day>14</day><month>7</month><year>2019</year></date><date date-type="rev-recd"><day>2</day><month>10</month><year>2019</year></date><date date-type="accepted"><day>15</day><month>10</month><year>2019</year></date></history><permissions><copyright-statement>Copyright © 2019 Bicky Thapa et al.</copyright-statement><copyright-year>2019</copyright-year><license xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><p>Immune-checkpoint inhibitors (ICIs) have revolutionized the treatment of cancer, yet therapy is often hampered by immune-related adverse events (irAEs) which range from mild to severe life-threatening events. Musculoskeletal (MSK) irAEs leading to discontinuation of ICIs are uncommon but increasingly recognized. We report a challenging case of severe immune-related seronegative inflammatory arthritis due to nivolumab in a patient with stage IV metastatic adenocarcinoma.</p></abstract></article-meta></front><floats-group><fig id="fig1" orientation="portrait" position="float"><label>Figure 1</label><caption><p>Ultrasound (US) of the left lower extremity: (a) Baker's cyst. (b) Follow-up US showing the increased size of baker's cyst. (c) Image depicting ruptured Baker's cyst.</p></caption><graphic xlink:href="CRIRH2019-1326734.001"></graphic></fig><fig id="fig2" orientation="portrait" position="float"><label>Figure 2</label><caption><p>X-ray of the left elbow joint and bilateral knee joints. (a) Moderate osteophytosis at the humeroulnar articulation and involving the radial head with mild joint space narrowing and no joint effusion. (b) Anterior-posterior weight-bearing view; no acute fracture/dislocation, and joint spaces grossly preserved.</p></caption><graphic xlink:href="CRIRH2019-1326734.002"></graphic></fig><fig id="fig3" orientation="portrait" position="float"><label>Figure 3</label><caption><p>Computed tomography (CT) scan of the chest with contrast before and after nivolumab. (a) CT chest before initiation of nivolumab; an axial image depicting significant mediastinal and right hilar lymphadenopathy. (b) CT chest after 12 cycles of nivolumab; no hilar or mediastinal lymphadenopathy identified.</p></caption><graphic xlink:href="CRIRH2019-1326734.003"></graphic></fig><fig id="fig4" orientation="portrait" position="float"><label>Figure 4</label><caption><p>Flowchart illustrating the complete clinical course of the patient. ANA: antinuclear antibody, US: ultrasound, MTX: methotrexate, HCQ: hydroxychloroquine, DMARDs: disease-modifying antirheumatic drugs.</p></caption><graphic xlink:href="CRIRH2019-1326734.004"></graphic></fig><table-wrap id="tab1" orientation="portrait" position="float"><label>Table 1</label><caption><p>Immunologic workup.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Immunology/serology</th><th align="center" rowspan="1" colspan="1">Reference range</th><th align="center" rowspan="1" colspan="1">Result</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">ANA</td><td align="center" rowspan="1" colspan="1">Negative</td><td align="center" rowspan="1" colspan="1">Positive</td></tr><tr><td align="left" rowspan="1" colspan="1">ANA titer</td><td align="center" rowspan="1" colspan="1">Negative</td><td align="center" rowspan="1" colspan="1">1 : 160</td></tr><tr><td align="left" rowspan="1" colspan="1">ANA pattern</td><td align="center" rowspan="1" colspan="1">Unknown</td><td align="center" rowspan="1" colspan="1">Nucleolar</td></tr><tr><td align="left" rowspan="1" colspan="1">DNA antibody</td><td align="center" rowspan="1" colspan="1"><30 IU/mL</td><td align="center" rowspan="1" colspan="1">22</td></tr><tr><td align="left" rowspan="1" colspan="1">RNP antibody</td><td align="center" rowspan="1" colspan="1"><1.0</td><td align="center" rowspan="1" colspan="1"><0.2</td></tr><tr><td align="left" rowspan="1" colspan="1">Ribosomal RNP</td><td align="center" rowspan="1" colspan="1"><1.0</td><td align="center" rowspan="1" colspan="1"><0.2</td></tr><tr><td align="left" rowspan="1" colspan="1">SSB antibody</td><td align="center" rowspan="1" colspan="1"><1.0</td><td align="center" rowspan="1" colspan="1"><0.2</td></tr><tr><td align="left" rowspan="1" colspan="1">Sm antibody</td><td align="center" rowspan="1" colspan="1"><1.0</td><td align="center" rowspan="1" colspan="1"><0.2</td></tr><tr><td align="left" rowspan="1" colspan="1">SSA antibody</td><td align="center" rowspan="1" colspan="1"><1.0</td><td align="center" rowspan="1" colspan="1"><0.2</td></tr><tr><td align="left" rowspan="1" colspan="1">Scleroderma Ab, IgG</td><td align="center" rowspan="1" colspan="1"><1.0</td><td align="center" rowspan="1" colspan="1"><0.2</td></tr><tr><td align="left" rowspan="1" colspan="1">Jo 1 antibody</td><td align="center" rowspan="1" colspan="1"><1.0</td><td align="center" rowspan="1" colspan="1"><0.2</td></tr><tr><td align="left" rowspan="1" colspan="1">Chromatin antibody</td><td align="center" rowspan="1" colspan="1"><1.0</td><td align="center" rowspan="1" colspan="1"><0.2</td></tr><tr><td align="left" rowspan="1" colspan="1">Centromere Ab</td><td align="center" rowspan="1" colspan="1"><1.0</td><td align="center" rowspan="1" colspan="1"><0.2</td></tr><tr><td align="left" rowspan="1" colspan="1">Rheumatoid factor</td><td align="center" rowspan="1" colspan="1"><16 IU/mL</td><td align="center" rowspan="1" colspan="1"><10</td></tr><tr><td align="left" rowspan="1" colspan="1">CCP antibody, IgG</td><td align="center" rowspan="1" colspan="1"><20 units</td><td align="center" rowspan="1" colspan="1"><15</td></tr></tbody></table><table-wrap-foot><fn><p>ANA: antinuclear antibody; DNA: deoxyribonucleic acid; RNP: ribonucleoprotein; SSB: anti-Sjögren's syndrome type B; SSA: anti-Sjögren's syndrome type B; Ab: antibody; CCP: cyclic citrullinated peptide; IU: international unit.</p></fn></table-wrap-foot></table-wrap><table-wrap id="tab2" orientation="portrait" position="float"><label>Table 2</label><caption><p>Summary of published case series or case report on rheumatologic/musculoskeletal immune-related adverse effects (irAEs).</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Case series/report(s)</th><th align="center" rowspan="1" colspan="1">Number of patients</th><th align="center" rowspan="1" colspan="1">Immune-checkpoint inhibitor</th><th align="center" rowspan="1" colspan="1">Primary malignancy</th><th align="center" rowspan="1" colspan="1">Pattern</th><th align="center" rowspan="1" colspan="1">Joint involvement</th><th align="center" rowspan="1" colspan="1">Symmetrical/Asymmetrical</th><th align="center" rowspan="1" colspan="1">Axial/appendicular</th><th align="center" rowspan="1" colspan="1">Clinical diagnosis</th><th align="center" rowspan="1" colspan="1">Serology</th><th align="center" rowspan="1" colspan="1">Therapy</th><th align="center" rowspan="1" colspan="1">Steroid dose (for arthritis patients only)</th><th align="center" rowspan="1" colspan="1">Response</th><th align="center" rowspan="1" colspan="1">ICI status</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Chan et al. [<xref rid="B17" ref-type="bibr">17</xref>]</td><td align="center" rowspan="1" colspan="1">2</td><td align="center" rowspan="1" colspan="1">Anti-PD1: 2</td><td align="center" rowspan="1" colspan="1">Melanoma: 2</td><td align="center" rowspan="1" colspan="1">Seronegative arthritis: 2</td><td align="center" rowspan="1" colspan="1">Polyarthritis: 2</td><td align="center" rowspan="1" colspan="1">NA</td><td align="center" rowspan="1" colspan="1">None</td><td align="center" rowspan="1" colspan="1">Inflammatory arthritis</td><td align="center" rowspan="1" colspan="1">RF: −ve, anti-CCP: −ve, ANA: −ve</td><td align="center" rowspan="1" colspan="1">Opioid analgesics: 1, pamidronate, NSAIDs and DMARDs (sulfasalazine, HCQ): 1</td><td align="center" rowspan="1" colspan="1">Steroid not used</td><td align="center" rowspan="1" colspan="1">Improvement: 2</td><td align="center" rowspan="1" colspan="1">Continued: 1, held: 1</td></tr><tr><td align="left" rowspan="1" colspan="1">Law-Ping-Man et al. [<xref rid="B22" ref-type="bibr">22</xref>]</td><td align="center" rowspan="1" colspan="1">1</td><td align="center" rowspan="1" colspan="1">Anti-PD1</td><td align="center" rowspan="1" colspan="1">NSCLC</td><td align="center" rowspan="1" colspan="1">Psoriatic arthritis</td><td align="center" rowspan="1" colspan="1">Oligoarthritis</td><td align="center" rowspan="1" colspan="1">Asymmetrical</td><td align="center" rowspan="1" colspan="1">None</td><td align="center" rowspan="1" colspan="1">Inflammatory arthritis</td><td align="center" rowspan="1" colspan="1">RF: −ve, anti-CCP: −ve, ANA: −ve</td><td align="center" rowspan="1" colspan="1">Steroid, DMARDs (MTX)</td><td align="center" rowspan="1" colspan="1">Prednisone (15 mg/day)</td><td align="center" rowspan="1" colspan="1">Improvement</td><td align="center" rowspan="1" colspan="1">Continued</td></tr><tr><td align="left" rowspan="1" colspan="1">Ruiz-Bañobre et al. [<xref rid="B23" ref-type="bibr">23</xref>]</td><td align="center" rowspan="1" colspan="1">1</td><td align="center" rowspan="1" colspan="1">Anti-PD1</td><td align="center" rowspan="1" colspan="1">NSCLC</td><td align="center" rowspan="1" colspan="1">Psoriatic arthritis</td><td align="center" rowspan="1" colspan="1">Polyarthritis</td><td align="center" rowspan="1" colspan="1">NA</td><td align="center" rowspan="1" colspan="1">NR</td><td align="center" rowspan="1" colspan="1">Inflammatory arthritis</td><td align="center" rowspan="1" colspan="1">RF: −ve, anti-CCP: −ve, ANA: −ve</td><td align="center" rowspan="1" colspan="1">IA steroid, steroid, NSAIDs, DMARDS (MTX, sulfasalazine)</td><td align="center" rowspan="1" colspan="1">Methylprednisone (4 mg/day)</td><td align="center" rowspan="1" colspan="1">Improvement</td><td align="center" rowspan="1" colspan="1">Continued</td></tr><tr><td align="left" rowspan="1" colspan="1">Kim et al. [<xref rid="B24" ref-type="bibr">24</xref>]</td><td align="center" rowspan="1" colspan="1">3</td><td align="center" rowspan="1" colspan="1">Anti-PD1: 1, anti-PD1 and anti-CTLA-4: 2</td><td align="center" rowspan="1" colspan="1">Melanoma: 3</td><td align="center" rowspan="1" colspan="1">Seronegative arthritis: 3</td><td align="center" rowspan="1" colspan="1">Polyarthritis: 3</td><td align="center" rowspan="1" colspan="1">Symmetrical: 3</td><td align="center" rowspan="1" colspan="1">None</td><td align="center" rowspan="1" colspan="1">Arthritis</td><td align="center" rowspan="1" colspan="1">RF: −ve, anti-CCP Ab: −ve, ANA: 1</td><td align="center" rowspan="1" colspan="1">Prednisone and anti-IL-6 Ab: 2, anti-IL-6 Ab (tocilizumab): 1</td><td align="center" rowspan="1" colspan="1">Prednisone (40 mg/day)</td><td align="center" rowspan="1" colspan="1">Improvement: 3</td><td align="center" rowspan="1" colspan="1">NR</td></tr><tr><td align="left" rowspan="1" colspan="1">Kuswanto et al. [<xref rid="B19" ref-type="bibr">19</xref>]</td><td align="center" rowspan="1" colspan="1">4</td><td align="center" rowspan="1" colspan="1">Anti-PD1: 4</td><td align="center" rowspan="1" colspan="1">RCC: 4</td><td align="center" rowspan="1" colspan="1">Seronegative arthritis: 3, PMR: 1</td><td align="center" rowspan="1" colspan="1">Polyarthritis: 3</td><td align="center" rowspan="1" colspan="1">Symmetrical: 2</td><td align="center" rowspan="1" colspan="1">Pelvic girdle: 1</td><td align="center" rowspan="1" colspan="1">Inflammatory arthritis</td><td align="center" rowspan="1" colspan="1">RF: NA, anti-CCP Ab: NA, ANA: NA</td><td align="center" rowspan="1" colspan="1">Steroid: 1, steroid and IA steroid: 1, steroid and DMARDs (MTX): 1, infliximab: 1</td><td align="center" rowspan="1" colspan="1">Prednisone (50–20 mg/day)</td><td align="center" rowspan="1" colspan="1">Improvement: 4</td><td align="center" rowspan="1" colspan="1">Held: 3</td></tr><tr><td align="left" rowspan="1" colspan="1">Cappelli et al. [<xref rid="B25" ref-type="bibr">25</xref>]</td><td align="center" rowspan="1" colspan="1">9</td><td align="center" rowspan="1" colspan="1">Anti-PD1: 2, anti-PD1 and anti-CTLA-4: 7</td><td align="center" rowspan="1" colspan="1">RCC: 1, small cell lung cancer: 1, melanoma: 3, NSCLC: 4</td><td align="center" rowspan="1" colspan="1">Seronegative arthritis: 9</td><td align="center" rowspan="1" colspan="1">Polyarthritis: 8, oligoarthritis: 1</td><td align="center" rowspan="1" colspan="1">NR</td><td align="center" rowspan="1" colspan="1">Back pain: 1</td><td align="center" rowspan="1" colspan="1">Inflammatory arthritis</td><td align="center" rowspan="1" colspan="1">RF: −ve, anti-CCP Ab: −ve, ANA: 1</td><td align="center" rowspan="1" colspan="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</td><td align="center" rowspan="1" colspan="1">Prednisone (40–10 mg/day), 120 mg for 1 patient</td><td align="center" rowspan="1" colspan="1">Improvement: 7, partial response: 1, NR: 1</td><td align="center" rowspan="1" colspan="1">NR</td></tr><tr><td align="left" rowspan="1" colspan="1">Calabrese et al. [<xref rid="B20" ref-type="bibr">20</xref>]</td><td align="center" rowspan="1" colspan="1">10</td><td align="center" rowspan="1" colspan="1">Anti-PD1: 1, anti-PD1 and anti-CTLA-4: 6</td><td align="center" rowspan="1" colspan="1">NSCLC: 1, RCC: 2, melanoma: 4</td><td align="center" rowspan="1" colspan="1">Seronegative arthritis: 7, PMR: 3</td><td align="center" rowspan="1" colspan="1">Polyarthritis: 7</td><td align="center" rowspan="1" colspan="1">Symmetrical: 6, asymmetrical: 1</td><td align="center" rowspan="1" colspan="1">None</td><td align="center" rowspan="1" colspan="1">Arthritis</td><td align="center" rowspan="1" colspan="1">RF: 1, anti-CCP Ab: −ve, ANA: 1</td><td align="center" rowspan="1" colspan="1">Prednisone: 6, prednisone and DMARDs (HCQ, MTX, infliximab, etanercept, adalimumab): 4</td><td align="center" rowspan="1" colspan="1">Prednisone (40–15 mg/day)</td><td align="center" rowspan="1" colspan="1">Significant improvement: 4, moderate improvement: 4, minimal improvement: 2</td><td align="center" rowspan="1" colspan="1">Held: 4, continued: 3</td></tr><tr><td align="left" rowspan="1" colspan="1">Belkhir et al. [<xref rid="B26" ref-type="bibr">26</xref>]</td><td align="center" rowspan="1" colspan="1">10</td><td align="center" rowspan="1" colspan="1">Anti-PD1/PD-L1: 9, anti-PD1 and anti-CTLA-4: 1</td><td align="center" rowspan="1" colspan="1">Melanoma: 3, lung adenocarcinoma: 2, endometrial adenocarcinoma: 1, squamous cell carcinoma of the vagina: 1, mesothelioma: 1, colon adenocarcinoma: 1, gastric adenocarcinoma: 1</td><td align="center" rowspan="1" colspan="1">RA: 6, PMR: 4</td><td align="center" rowspan="1" colspan="1">NR</td><td align="center" rowspan="1" colspan="1">NR</td><td align="center" rowspan="1" colspan="1">NR</td><td align="center" rowspan="1" colspan="1">Inflammatory arthritis</td><td align="center" rowspan="1" colspan="1">RF: 4, anti-CCP Ab: 6, ANA: 1</td><td align="center" rowspan="1" colspan="1">Steroid: 7, NSAIDs: 1, NSAIDs and DMARDs (MTX, HCQ): 2</td><td align="center" rowspan="1" colspan="1">Prednisone (20–10 mg/day) 60 mg for 1 patient</td><td align="center" rowspan="1" colspan="1">Improvement: 10</td><td align="center" rowspan="1" colspan="1">Continued: 9</td></tr><tr><td align="left" rowspan="1" colspan="1">Le Burel et al. [<xref rid="B27" ref-type="bibr">27</xref>]</td><td align="center" rowspan="1" colspan="1">17</td><td align="center" rowspan="1" colspan="1">Anti-PD1/PD-L1: 15, anti-PD1 and anti-CTLA-4: 2</td><td align="center" rowspan="1" colspan="1">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</td><td align="center" rowspan="1" colspan="1">RA: 3, PMR: 4, psoriatic arthritis: 3, seronegative arthritis: 7</td><td align="center" rowspan="1" colspan="1">Polyarthritis: 13</td><td align="center" rowspan="1" colspan="1">Symmetrical: 11, asymmetrical: 1</td><td align="center" rowspan="1" colspan="1">NR</td><td align="center" rowspan="1" colspan="1">Inflammatory arthritis</td><td align="center" rowspan="1" colspan="1">RF: 3, anti-CCP Ab: 3, ANA: 1</td><td align="center" rowspan="1" colspan="1">Steroids: 14, steroid and DMARDs (MTX): 2</td><td align="center" rowspan="1" colspan="1">NA</td><td align="center" rowspan="1" colspan="1">Improvement: 9, resolution: 7, stable: 1</td><td align="center" rowspan="1" colspan="1">NA</td></tr><tr><td align="left" rowspan="1" colspan="1">Le Bakhaya et al. [<xref rid="B28" ref-type="bibr">28</xref>]</td><td align="center" rowspan="1" colspan="1">26</td><td align="center" rowspan="1" colspan="1">Anti-PD1: 23, anti-PD1 and anti-CTLA-4: 3</td><td align="center" rowspan="1" colspan="1">Melanoma: 25, Merkel cell carcinoma: 1</td><td align="center" rowspan="1" colspan="1">Arthritis: 10, activated osteoarthritis: 5, arthralgia (not specified): 11</td><td align="center" rowspan="1" colspan="1">Polyarthritis: 7, oligoarthritis: 19</td><td align="center" rowspan="1" colspan="1">Symmetrical: 16</td><td align="center" rowspan="1" colspan="1">NR</td><td align="center" rowspan="1" colspan="1">Arthralgia</td><td align="center" rowspan="1" colspan="1">RF: 2, anti-CCP ab: 1, ANA: 1</td><td align="center" rowspan="1" colspan="1">NSAIDs: 19, steroid: 5, DMARDs (sulfasalazine, HCQ): 2</td><td align="center" rowspan="1" colspan="1">Prednisone (5–10 mg/day)</td><td align="center" rowspan="1" colspan="1">Complete response: 4, partial response: 15, stable disease: 5</td><td align="center" rowspan="1" colspan="1">Held: 2</td></tr><tr><td align="left" rowspan="1" colspan="1">Ngo et al. [<xref rid="B29" ref-type="bibr">29</xref>]</td><td align="center" rowspan="1" colspan="1">1</td><td align="center" rowspan="1" colspan="1">Anti-PD1</td><td align="center" rowspan="1" colspan="1">Melanoma</td><td align="center" rowspan="1" colspan="1">Seronegative arthritis</td><td align="center" rowspan="1" colspan="1">Polyarthritis</td><td align="center" rowspan="1" colspan="1">Symmetrical</td><td align="center" rowspan="1" colspan="1">None</td><td align="center" rowspan="1" colspan="1">Inflammatory arthritis</td><td align="center" rowspan="1" colspan="1">RF: −ve, anti-CCP: −ve, ANA: −ve</td><td align="center" rowspan="1" colspan="1">Steroid</td><td align="center" rowspan="1" colspan="1">Prednisone (40 mg/day)</td><td align="center" rowspan="1" colspan="1">Improvement</td><td align="center" rowspan="1" colspan="1">Continued</td></tr><tr><td align="left" rowspan="1" colspan="1">Haikal et al. [<xref rid="B21" ref-type="bibr">21</xref>]</td><td align="center" rowspan="1" colspan="1">1</td><td align="center" rowspan="1" colspan="1">Anti-PD1</td><td align="center" rowspan="1" colspan="1">Melanoma</td><td align="center" rowspan="1" colspan="1">Seronegative arthritis</td><td align="center" rowspan="1" colspan="1">Polyarthritis</td><td align="center" rowspan="1" colspan="1">Symmetrical</td><td align="center" rowspan="1" colspan="1">None</td><td align="center" rowspan="1" colspan="1">Arthritis</td><td align="center" rowspan="1" colspan="1">RF: −ve, anti-CCP: −ve</td><td align="center" rowspan="1" colspan="1">Steroid and DMARDs (HCQ)</td><td align="center" rowspan="1" colspan="1">Low-dose steroid</td><td align="center" rowspan="1" colspan="1">Improvement</td><td align="center" rowspan="1" colspan="1">NR</td></tr><tr><td align="left" rowspan="1" colspan="1">Inamo et al. [<xref rid="B18" ref-type="bibr">18</xref>]</td><td align="center" rowspan="1" colspan="1">3</td><td align="center" rowspan="1" colspan="1">Anti-PD1: 3</td><td align="center" rowspan="1" colspan="1">Lung adenocarcinoma: 1, lung squamous cell carcinoma: 1, ovarian cancer: 1</td><td align="center" rowspan="1" colspan="1">Seronegative arthritis: 3</td><td align="center" rowspan="1" colspan="1">Polyarthritis: 2, oligoarthritis: 1</td><td align="center" rowspan="1" colspan="1">Symmetrical: 3</td><td align="center" rowspan="1" colspan="1">None</td><td align="center" rowspan="1" colspan="1">Inflammatory arthritis</td><td align="center" rowspan="1" colspan="1">RF: −ve, Anti-CCP Ab: −ve, ANA: −ve</td><td align="center" rowspan="1" colspan="1">NSAIDs: 1, opioid: 1, NSAIDs and prednisone: 1</td><td align="center" rowspan="1" colspan="1">Prednisone (20 mg/day) for 1 patient only</td><td align="center" rowspan="1" colspan="1">Improvement: 3</td><td align="center" rowspan="1" colspan="1">NR</td></tr><tr><td align="left" rowspan="1" colspan="1">Smith and Bass [<xref rid="B30" ref-type="bibr">30</xref>]</td><td align="center" rowspan="1" colspan="1">10</td><td align="center" rowspan="1" colspan="1">Anti- PD1: 3, anti-PD-1 and anti-CTLA-4: 7</td><td align="center" rowspan="1" colspan="1">Melanoma: 4, lung adenocarcinoma: 2, RCC: 1, Merkel: 1, anal cancer: 1, cervical cancer: 1</td><td align="center" rowspan="1" colspan="1">RA: 3, PMR: 1, others: 6</td><td align="center" rowspan="1" colspan="1">Polyarthritis: 4, oligoarthritis: 4, tenosynovitis: 2</td><td align="center" rowspan="1" colspan="1">NA</td><td align="center" rowspan="1" colspan="1">NA</td><td align="center" rowspan="1" colspan="1">Inflammatory arthritis</td><td align="center" rowspan="1" colspan="1">RF: NA, anti- CCP Ab: 2, ANA: 6</td><td align="center" rowspan="1" colspan="1">Steroid: 6, steroid and DMARDs (HCQ, sulfasalazine, MTX, mycophenolate mofetil): 4</td><td align="center" rowspan="1" colspan="1">Prednisone (20–10 mg/day)</td><td align="center" rowspan="1" colspan="1">Improvement: 4, resolution: 6</td><td align="center" rowspan="1" colspan="1">Held: 1</td></tr><tr><td align="left" rowspan="1" colspan="1">Lidar et al. [<xref rid="B31" ref-type="bibr">31</xref>]</td><td align="center" rowspan="1" colspan="1">12</td><td align="center" rowspan="1" colspan="1">Anti-PD1: 8, anti-CTLA 4: 1, anti-PD1 and anti-CTLA-4: 3</td><td align="center" rowspan="1" colspan="1">Melanoma: 10, sinonasal carcinoma: 1, endometrial carcinoma: 1</td><td align="center" rowspan="1" colspan="1">Seronegative arthritis: 12</td><td align="center" rowspan="1" colspan="1">Polyarthritis: 10, oligoarthritis: 1, monoarthritis: 1</td><td align="center" rowspan="1" colspan="1">NR</td><td align="center" rowspan="1" colspan="1">None</td><td align="center" rowspan="1" colspan="1">Inflammatory arthritis</td><td align="center" rowspan="1" colspan="1">RF: −ve, anti-CCP Ab: none, ANA: −ve</td><td align="center" rowspan="1" colspan="1">NSAIDs, steroid: 5, steroid and MTX: 2, NSAIDs, steroid, MTX: 5</td><td align="center" rowspan="1" colspan="1">Prednisone (>20 mg/day)</td><td align="center" rowspan="1" colspan="1">Improvement: 11, unknown: 1</td><td align="center" rowspan="1" colspan="1">Held: 3, continued: 3, off therapy: 6</td></tr><tr><td align="left" rowspan="1" colspan="1">Kostine et al. [<xref rid="B32" ref-type="bibr">32</xref>]</td><td align="center" rowspan="1" colspan="1">35</td><td align="center" rowspan="1" colspan="1">Anti-PD1/PD-L1: 33, anti-CTLA-4: 1, anti-PD-L1 and anti-CTLA- 4: 1</td><td align="center" rowspan="1" colspan="1">Melanoma: 16, lung cancer: 12, RCC: 6, Merkel cell carcinoma: 1</td><td align="center" rowspan="1" colspan="1">RA: 7, PMR: 11, psoriatic arthritis: 2, others: 15</td><td align="center" rowspan="1" colspan="1">Mostly polyarthritis: exact no. not reported</td><td align="center" rowspan="1" colspan="1">Mostly symmetrical</td><td align="center" rowspan="1" colspan="1">Back pain: 10</td><td align="center" rowspan="1" colspan="1">Inflammatory and noninflammatory arthritis</td><td align="center" rowspan="1" colspan="1">RF: −ve, anti-CCP Ab: 1, ANA: 4</td><td align="center" rowspan="1" colspan="1">Steroid: 18, NSAIDs: 5, steroid and DMARDs (MTX): 2, intraarticular steroid: 1</td><td align="center" rowspan="1" colspan="1">Prednisone (mean dose 15 mg)</td><td align="center" rowspan="1" colspan="1">Improvement: 35</td><td align="center" rowspan="1" colspan="1">Continued: 34</td></tr><tr><td align="left" rowspan="1" colspan="1">Leipe et al. [<xref rid="B33" ref-type="bibr">33</xref>]</td><td align="center" rowspan="1" colspan="1">14</td><td align="center" rowspan="1" colspan="1">Anti-PD1: 10, anti-PD1 and anti-CTLA4: 4</td><td align="center" rowspan="1" colspan="1">Melanoma: 10, NSCLC: 5</td><td align="center" rowspan="1" colspan="1">Arthritis: 14, PMR: 5, Sicca syndrome: 2, myositis: 1</td><td align="center" rowspan="1" colspan="1">Polyarthritis: 2, oligoarthritis: 5, monoarthritis: 7</td><td align="center" rowspan="1" colspan="1">NR</td><td align="center" rowspan="1" colspan="1">NA</td><td align="center" rowspan="1" colspan="1">New-onset arthralgia and arthritis</td><td align="center" rowspan="1" colspan="1">RF: 5, anti-CCP: 1, ANA: 9</td><td align="center" rowspan="1" colspan="1">Steroid: 3, steroid and DMRDs (MTX): 6, NSAIDs: 2, IA steroid: 8</td><td align="center" rowspan="1" colspan="1">NR</td><td align="center" rowspan="1" colspan="1">Improvement: 13</td><td align="center" rowspan="1" colspan="1">Continued: 14</td></tr><tr><td align="left" rowspan="1" colspan="1">Narváez et al. [<xref rid="B34" ref-type="bibr">34</xref>]</td><td align="center" rowspan="1" colspan="1">11</td><td align="center" rowspan="1" colspan="1">Anti-PD1/PD-L1: 10, anti-PD1 and anti-CTLA4: 1</td><td align="center" rowspan="1" colspan="1">Lymphoma: 2, lung cancer: 4, RCC: 1, epithelioid mesothelioma: 1, pancreatic neuroendocrine cancer: 1, melanoma: 1, urothelial carcinoma: 1</td><td align="center" rowspan="1" colspan="1">Seronegative arthritis: 5, PMR: 1, Sicca syndrome: 2, inflammatory myositis with fasciitis: 2, paraneoplastic acral vascular syndrome: 1</td><td align="center" rowspan="1" colspan="1">Polyarthritis: 4, oligoarthritis: 1</td><td align="center" rowspan="1" colspan="1">Mostly symmetrical</td><td align="center" rowspan="1" colspan="1">None</td><td align="center" rowspan="1" colspan="1">Arthritis</td><td align="center" rowspan="1" colspan="1">RF: −ve, anti-CCP: −ve, ANA: −ve</td><td align="center" rowspan="1" colspan="1">Steroid: 4, NSAIDs: 1, steroid and DMARDs (HCQ): 3</td><td align="center" rowspan="1" colspan="1">Prednisone (cobra light schedule): 2 patients, prednisone 60 mg daily for 1 patient and methylprednisone 20 mg daily for 1 patient</td><td align="center" rowspan="1" colspan="1">Improvement: 10</td><td align="center" rowspan="1" colspan="1">Continued: 6</td></tr></tbody></table></table-wrap></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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