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Observational Study
. 2025 Jan;92(1):105795.
doi: 10.1016/j.jbspin.2024.105795. Epub 2024 Oct 22.

Resolution of immune checkpoint inhibitors-induced inflammatory arthritis while maintaining active treatment with checkpoint inhibitors and after its discontinuation: An observational study

Alexandra Ladouceur  1 , Thomas Barnetche  2 , Sorilla Prey  3 , Caroline Dutriaux  3 , Émilie Gerard  3 , Anne Pham-Ledard  4 , Marie Beylot-Barry  3 , Maeva Zysman  5 , Rémi Veillon  5 , Charlotte Domblides  6 , Amaury Daste  6 , Marine Gross-Goupil  6 , Baptiste Sionneau  6 , Felix Lefort  6 , Larroquette Mathieu  6 , Christophe Richez  2 , Marie-Elise Truchetet  2 , Thierry Schaeverbeke  2 , Marie Kostine  2
Affiliations
Observational Study

Resolution of immune checkpoint inhibitors-induced inflammatory arthritis while maintaining active treatment with checkpoint inhibitors and after its discontinuation: An observational study

Alexandra Ladouceur et al. Joint Bone Spine. 2025 Jan.

Abstract

Introduction: Immune checkpoint inhibitors-induced inflammatory arthritis (ICI-IA) affects about 5% of ICI recipients. We aimed (1) to characterize the resolution of ICI-IA during ICI treatment and after ICI discontinuation and (2) to assess how ICI-IA influences ICI management across time.

Methods: All ICI-treated patients referred to rheumatology at Bordeaux University Hospital were identified and patients with ICI-IA with a follow-up of≥6months after ICI-IA onset were included. Resolution of ICI-IA was defined by discontinuation of ICI-IA medications without recurrence of ICI-IA symptoms.

Results: Resolution of ICI-IA occurred in 13 of 80 patients (16%) while maintaining active ICI treatment, mainly in patients with polymyalgia rheumatica (PMR)-like clinical presentation (P=0.03). Synovitis was more frequent in those whose ICI-IA persisted throughout ICI treatment. In patients with persistent ICI-IA throughout ICI treatment, 34 (50%) and 47 (70%) resolved at 6- and 12-months post-ICI discontinuation, respectively. Reason for terminating ICI was more frequently cancer stable or in remission in those who still had active ICI-IA at 6- and 12-months post-ICI discontinuation. Both progression-free survival and overall survival were longer in the groups with active ICI-IA at 6- and 12-months after ICI discontinuation.

Discussion: In this cohort, ICI was safely continued in most patients experiencing ICI-IA. About one sixth of ICI-IA resolved despite maintaining active ICI treatment and allowing ICI-IA treatment discontinuation without recurrence of symptoms, mainly in those with PMR-like presentation. Larger studies are needed to determine predicting factors of resolving ICI-IA to minimize exposure to immunosuppressive treatment.

Keywords: Arthritis; Immune checkpoint inhibitors; Immune-related adverse events; Tumour outcomes.

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Conflict of interest statement

Disclosure of interest AL: speaker fees for AstraZeneca. TB, APL, MBB, BS, ML, CR, MET, MK declare that they have no competing interest. SP and CD: congress fees and investigator in clinical trials: BMS and MSD. EG: congress fees and investigator for BMS and MSD. MZ: grants from AVAD and grants from FRM. RV: consulting fees and speaker fees: Roche; registration reimbursement: Pfizer and AstraZeneca; speaker and registration reimbursement: BMS and MSD. AD: consulting or advisory role: Merck, MSD, BMS, Merus; travel, accommodations, expenses: BMS, Merck. MGG: consulting or advisory role: AstraZeneca, Merck, Pfizer, MSD, BMS, Roche; travel, accommodations, expenses: MSD, Janssen. FL: congress fees, consulting fees, and sub-investigator in trials: AstraZeneca, BMS, MSD, Roche, Pfizer. TS: clinical research: AbbVie, Abivax, Biogen, Pfizer, Lilly, MSD, Novartis, Sandoz; advisory boards: AbbVie, BMS, Lilly, Novartis, Pfizer, Sanofi; education: AbbVie, Biogen, BMS, Galapagos, Lilly, Janssen, Novartis, Nordic Pharma, Pfizer, Viatris; help for research: Pfizer, Lilly, Abbvie, Biogen.

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