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Immune checkpoint inhibitors (ICIs; e.g., ipilimumab [Yervoy], nivolumab [Opdivo], pembrolizumab [Keytruda]) increasingly are being used to treat advanced cancers. However, these agents have been associated with immune-related adverse events, including life-threatening pneumonitis and colitis, autoimmune thyroid disease, hypophysitis, and vitiligo.
Among about 700 patients who received ICIs at Johns Hopkins University, 13 developed inflammatory arthritis or sicca symptoms after starting therapy with ipilimumab or nivolumab. Nine patients presented with inflammatory arthritis, none of whom tested positive for rheumatoid factor or anti–cyclic citrullinated peptide antibodies. A rheumatoid arthritis (RA)–like syndrome developed in six of these …