Gómez-Puerta, José A.Lobo-Prat, DavidPérez-García, CarolinaPonce, AndrésFrade-Sosa, BeatrizMillán Arciniegas, Ana MilenaOjeda Morillo, Fabiola AlejandraRuiz-Esquide, VirginiaCorominas, Héctor2022-11-042022-11-042022Gómez-Puerta JA, Lobo-Prat D, Perez-García C, Ponce A, Frade-Sosa B, Millán Arciniegas AM, et al. Clinical patterns and follow-up of inflammatory arthritis and other immune-related adverse events induced by checkpoint inhibitors. a multicenter study. Front Med (Lausanne). 2022 Jun 15; 9: 888377. DOI: 10.3389/fmed.2022.888377.2296-858Xhttp://hdl.handle.net/10230/54687Objectives: to describe different clinical patterns of rheumatic immune-related adverse events (irAEs) induced by immune checkpoint inhibitors (ICI) and their rheumatic and oncologic outcomes. Methods: we classified clinical syndromes according to five different categories: non-inflammatory arthralgias (NIA), rheumatoid arthritis (RA)-like, psoriatic arthritis (PsA)-like, polymyalgia rheumatica (PMR)-like, and a miscellaneous group of patients with other syndromes. We conducted a baseline visit and then follow-up in order to determine their clinical pattern, treatment response, and outcome. Results: we included 73 patients (64% male) with a mean age of 66.1 ± 11.6 years. Main underlying diagnosis was lung carcinoma in 29 (39%) patients, melanoma in 20 (27%), and renal-urothelial cancer in 11 (15%). Main ICI included Pembrolizumab in 24 (32%), Nivolumab 17 (23%), and Atezolizumab 7 (9 %). Seventeen out of seventy-three patients had an underlying rheumatic disease before ICI treatment. Fourteen patients developed other irAEs before or simultaneously with rheumatic syndromes. Main rheumatic irAEs included: RA-like in 31 (42.4%), NIA in 19 (26.0%), PMR-like in 10 (13.7%), and PsA-like in 5 (6.8%), among others. Median time from ICI to irAEs was 5 months (IQR 3-9). Those patients who received combined therapy, had a trend for an earlier presentation than those who received monotherapy (4.3 months IQR 1.85-17 vs. 6 months IQR 3-9.25, p = NS). Mean follow-up time was 14.0 ± 10.8 (SD, months). At the last visit, 47 % were taking glucocorticoids and 11% DMARD therapy. At the last visit, 13 (17.8%) patients remained with persistent arthritis, 19 (26%) had intermittent flares, and 39 (53.4%) had a self-limited pattern. Only in 15.1% of patients ICI therapy was discontinued. Conclusions: we described different patterns according to treatment and irAEs. Combined ICI therapy had an earlier onset of symptoms. Patients who presented as RA-like, had a higher risk of persistent arthritis. After a mean follow-up of more than 1 year, one-fifth of the patients remained with persistent arthritis and 11% required DMARD therapy.application/pdfengCopyright © 2022 Gómez-Puerta, Lobo-Prat, Perez-García, Ponce, Frade-sosa, Millán Arciniegas, Ojeda, Ruiz-Esquide and Corominas. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) https://creativecommons.org/licenses/by/4.0/. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.info:eu-repo/semantics/articlehttp://dx.doi.org/10.3389/fmed.2022.888377Adverse (side) effectsArthritisCheckpointImmunotherapyPolymyalgia rheumaticainfo:eu-repo/semantics/openAccess