{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T13:16:40Z","timestamp":1791465400877,"version":"4.3.4"},"reference-count":35,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,1,28]],"date-time":"2019-01-28T00:00:00Z","timestamp":1548633600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe the prevalence, clinical presentation, and management of rheumatic immune\u2010related adverse effects (Rh\u2010ir<jats:styled-content style=\"fixed-case\">AE<\/jats:styled-content>s) from immune checkpoint inhibitor (<jats:styled-content style=\"fixed-case\">ICI<\/jats:styled-content>) therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From a database of all patients who received any <jats:styled-content style=\"fixed-case\">ICI<\/jats:styled-content> at the Mayo Clinic Rochester, Minnesota campus between January 1, 2011 and March 1, 2018, we retrospectively identified those with Rh\u2010ir<jats:styled-content style=\"fixed-case\">AE<\/jats:styled-content>s, using diagnostic codes, search terms, and manual chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 1,293 patients who received any <jats:styled-content style=\"fixed-case\">ICI<\/jats:styled-content>, Rh\u2010ir<jats:styled-content style=\"fixed-case\">AE<\/jats:styled-content>s were clinically diagnosed in 43. Eighteen patients with Rh\u2010ir<jats:styled-content style=\"fixed-case\">AE<\/jats:styled-content>s who received <jats:styled-content style=\"fixed-case\">ICI<\/jats:styled-content> therapy elsewhere were also analyzed. Clinical syndromes included inflammatory arthritis (n = 34 [prevalence 2%]), myopathy (n = 10), and other rheumatic syndromes (n = 17). Inflammatory arthritis was most commonly polyarticular, and glucocorticoid treatment was required in 26 patients (76%). The mean \u00b1 <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content> duration of treatment was 18 \u00b1 18 weeks. Five patients (15%) also received disease\u2010modifying antirheumatic drugs, and <jats:styled-content style=\"fixed-case\">ICI<\/jats:styled-content> therapy had to be discontinued in 3 patients (9%). Myopathy was treated with glucocorticoids in all cases (mean \u00b1 <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content> treatment duration 15 \u00b1 17 weeks) and led to 2 deaths and permanent <jats:styled-content style=\"fixed-case\">ICI<\/jats:styled-content> discontinuation in 9 patients (90%). Other syndromes included connective tissue diseases, vasculitis, polymyalgia rheumatica\u2013like syndrome, and flare of preexisting rheumatic disease. Most (71%) were treated with immunosuppression, with 12% requiring <jats:styled-content style=\"fixed-case\">ICI<\/jats:styled-content> discontinuation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study represents the largest cohort of patients with Rh\u2010ir<jats:styled-content style=\"fixed-case\">AE<\/jats:styled-content>s reported to date. Most patients received long courses of immunosuppressive treatment, although discontinuation of <jats:styled-content style=\"fixed-case\">ICI<\/jats:styled-content> therapy was required in only a minority.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.40745","type":"journal-article","created":{"date-parts":[[2018,10,5]],"date-time":"2018-10-05T10:49:21Z","timestamp":1538736561000},"page":"468-475","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":142,"title":["Rheumatic Syndromes Associated With Immune Checkpoint Inhibitors: A Single\u2010Center Cohort of Sixty\u2010One Patients"],"prefix":"10.1002","volume":"71","author":[{"given":"Michael D.","family":"Richter","sequence":"first","affiliation":[{"name":"Mayo Clinic  Rochester Minnesota US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia","family":"Crowson","sequence":"additional","affiliation":[{"name":"Mayo Clinic  Rochester Minnesota US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa A.","family":"Kottschade","sequence":"additional","affiliation":[{"name":"Mayo Clinic  Rochester Minnesota US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi D.","family":"Finnes","sequence":"additional","affiliation":[{"name":"Mayo Clinic  Rochester Minnesota US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svetomir N.","family":"Markovic","sequence":"additional","affiliation":[{"name":"Mayo Clinic  Rochester Minnesota US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uma","family":"Thanarajasingam","sequence":"additional","affiliation":[{"name":"Mayo Clinic  Rochester Minnesota US"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,1,28]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2015.11.016"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/imr.12531"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/d41586-017-08702-7"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2017-212061"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-15-1136"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12964-016-0155-9"},{"key":"e_1_2_6_8_1","unstructured":"National Cancer Institute: National Institutes of Health.Common terminology criteria for adverse events (CTCAE).2009. 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