ObjectiveWe 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.MethodsWe 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.ResultsSixty 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).ConclusionICI-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.

ObjectiveTo assess whether the polymyalgia rheumatica (PMR)-like syndrome reported as an immune related adverse event (irAE) from checkpoint inhibitor therapy is consistent with the 2012 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) provisional criteria for PMR.MethodsThe cases were derived from two sources. Group 1 represents reported cases from three contributing centres. Group 2 was derived from a systematic review of the literature searching for all cases reported as PMR or PMR-like illness associated with checkpoint inhibitor therapy. Cases were assessed for the quality of reporting and then analysed to determine whether they fulfilled the 2012 EULAR/ACR provisional criteria for PMR.ResultsA total of 49 patients were included for analysis. Among the entire group, 37 (75%) were designated ‘complete’ indicating that they had sufficient data to reliably apply the 2012 EULAR/ACR criteria. 28 (75%) cases fulfilled complete criteria for PMR. A number of cases also demonstrated some clinical features unusual for idiopathic PMR.ConclusionThis study suggests a high proportion of reported cases of checkpoint inhibitor-related PMR fulfil preliminary criteria for PMR, yet in one quarter clinical details were incomplete making verification problematic. Furthermore, in the absence of a gold standard for the diagnosis of PMR, the relationship of checkpoint inhibitor-related PMR to the idiopathic form remains unclear.

NCT00166569.

Introduction/Objectives: Gender is an important patient characteristic that may be used to predict clinical presentation, disease progression, and therapeutic response. In recent studies, women with psoriatic arthritis (PsA) have reported less favorable function, increased fatigue, and decreased quality of life, compared to men. Less is known about gender differences with other patient-reported outcomes (PROs) such as pain and work limitations. Our purpose was to characterize gender differences in PROs in participants of the Utah Psoriasis Initiative (UPI) Arthritis Registry. Methods: In this cross-sectional study, PROs assessing pain, fatigue, quality of life, and function were compared between men and women enrolled in the UPI Arthritis Registry between January 2010 and November 2014. Work limitations were assessed in the subset of participants working for pay at the time of enrollment. Results: Participants included 115 men and 138 women. Women had less favorable PROs for pain, fatigue, patient-reported joint count, physical demands at work, work output, and function, as measured by both Health Assessment Questionnaire and the Psoriatic Arthritis Screening and Evaluation function subscale. Conclusions: Women experienced PsA differently than men, with higher fatigue, pain, work disability, and functional limitations. The etiology of the gender differences in PsA are unclear, and further research is indicated to better understand the role of hormones, gene expression, and other potential pathophysiologic differences between men and women.