Nivolumab-Induced Psoriatic Arthritis in a Patient With Advanced Small Cell Lung Cancer

Abstract

A 65-year-old woman with a medical history of well-controlled scalp psoriasis, chronic kidney disease stage 3, hypothyroidism, and chronic obstructive pulmonary disease was referred to rheumatology for increasing joint pains. The patient had a history of small cell lung cancer (SCLC) with lymph node involvement for 3 years. She had tried and failed carboplatin with etoposide, paclitaxel, topotecan, and chest and cranial radiation therapy. Nivolumab was started for SCLC at the dose of 240 mg every 2 weeks, and after 12 weeks, she started noticing joint pains in her hands, feet, and knees. She presented to the rheumatology office after using From the

First Report of De Novo Nivolumab-Induced Oligoarthritis in a Young Man With Relapsing Classic Hodgkin Lymphoma

“…This is the first report describing the occurrence of a seronegative oligoarthritis sine PsO in a young male undergoing N-treatment for relapsing cHL. Differently from the few related reports describing N-induced PsA, our patient is not 64 years or older, and he is not affected by lung cancer with occasionally clinically overt PsO 1,3,4 . Moreover, our case indicates that an N-induced de novo arthritis can occur very late after the beginning of N-treatment 5,6 and can persist despite N-discontinuation 4,7 .…”

“…Differently from the few related reports describing N-induced PsA, our patient is not 64 years or older, and he is not affected by lung cancer with occasionally clinically overt PsO. 1,3,4 Moreover, our case indicates that an N-induced de novo arthritis can occur very late after the beginning of N-treatment 5,6 and can persist despite N-discontinuation. 4,7 In our patient, we hypothesize that N-induced Th17 upregulation resulted in an imbalance of proinflammatory cytokines, which may contribute to the onset of the arthritis.…”

“…W e recently read with great interest the article by Jatwani et al, describing the case of a 65-old woman who experienced psoriatic arthritis (PsA) after 12 weeks of nivolumab (N) therapy for non-small cell lung cancer. 1 Here we report, for the first time, a de novo onset of seronegative oligoartritis in a white young man treated with N for classic Hodgkin lymphoma (cHL).…”

“…We recently read with great interest the article by Jatwani et al, describing the case of a 65-old woman who experienced psoriatic arthritis (PsA) after 12 weeks of nivolumab (N) therapy for non–small cell lung cancer 1 …”

Skin Manifestation Induced by Immune Checkpoint Inhibitors

“…In addition to cutaneous psoriasis, psoriatic arthritis is rarely induced. 21 , 22 Inflammatory arthritis may be induced by inflammatory cytokines due to nivolumab-induced Th17 upregulation. By contrast, cases of palmoplantar pustulosis during the use of ICIs are very few.…”