{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T21:59:22Z","timestamp":1790805562318,"version":"4.1.0"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,6,15]],"date-time":"2022-06-15T00:00:00Z","timestamp":1655251200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To describe different clinical patterns of rheumatic immune-related adverse events (irAEs) induced by immune checkpoint inhibitors (ICI) and their rheumatic and oncologic outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We classified clinical syndromes according to five different categories: non-inflammatory arthralgias (NIA), rheumatoid arthritis (RA)-like, psoriatic arthritis (PsA)-like, polymyalgia rheumatica (PMR)-like, and a miscellaneous group of patients with other syndromes. We conducted a baseline visit and then follow-up in order to determine their clinical pattern, treatment response, and outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 73 patients (64% male) with a mean age of 66.1 \u00b1 11.6 years. Main underlying diagnosis was lung carcinoma in 29 (39%) patients, melanoma in 20 (27%), and renal-urothelial cancer in 11 (15%). Main ICI included Pembrolizumab in 24 (32%), Nivolumab 17 (23%), and Atezolizumab 7 (9 %). Seventeen out of seventy-three patients had an underlying rheumatic disease before ICI treatment. Fourteen patients developed other irAEs before or simultaneously with rheumatic syndromes. Main rheumatic irAEs included: RA-like in 31 (42.4%), NIA in 19 (26.0%), PMR-like in 10 (13.7%), and PsA-like in 5 (6.8%), among others. Median time from ICI to irAEs was 5 months (IQR 3\u20139). Those patients who received combined therapy, had a trend for an earlier presentation than those who received monotherapy (4.3 months IQR 1.85\u201317 vs. 6 months IQR 3\u20139.25, <jats:italic>p<\/jats:italic> = NS). Mean follow-up time was 14.0 \u00b1 10.8 (SD, months). At the last visit, 47 % were taking glucocorticoids and 11% DMARD therapy. At the last visit, 13 (17.8%) patients remained with persistent arthritis, 19 (26%) had intermittent flares, and 39 (53.4%) had a self-limited pattern. Only in 15.1% of patients ICI therapy was discontinued.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We described different patterns according to treatment and irAEs. Combined ICI therapy had an earlier onset of symptoms. Patients who presented as RA-like, had a higher risk of persistent arthritis. After a mean follow-up of more than 1 year, one-fifth of the patients remained with persistent arthritis and 11% required DMARD therapy.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2022.888377","type":"journal-article","created":{"date-parts":[[2022,6,15]],"date-time":"2022-06-15T05:42:06Z","timestamp":1655271726000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":21,"title":["Clinical Patterns and Follow-Up of Inflammatory Arthritis and Other Immune-Related Adverse Events Induced by Checkpoint Inhibitors. A Multicenter Study"],"prefix":"10.3389","volume":"9","author":[{"given":"Jos\u00e9 A.","family":"G\u00f3mez-Puerta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Lobo-Prat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Perez-Garc\u00eda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s","family":"Ponce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"Frade-sosa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Milena","family":"Mill\u00e1n Arciniegas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiola","family":"Ojeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Ruiz-Esquide","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hector","family":"Corominas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,6,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1056\/NEJMra1703481","article-title":"Immune-related adverse events associated with immune checkpoint blockade","volume":"378","author":"Postow","year":"2018","journal-title":"New Eng J Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"e000412","DOI":"10.1136\/rmdopen-2016-000412","article-title":"Rheumatic immune-related adverse events of checkpoint therapy for cancer: case series of a new nosological entity","volume":"3","author":"Calabrese","year":"2017","journal-title":"RMD Open."},{"key":"B3","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1136\/annrheumdis-2017-212257","article-title":"Rheumatic disorders associated with immune checkpoint inhibitors in patients with cancer\u2014clinical aspects and relationship with tumour response: a single-centre prospective cohort study","volume":"77","author":"Kostine","year":"2018","journal-title":"Ann Rheum Dis."},{"key":"B4","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1002\/art.40745","article-title":"Rheumatic syndromes associated with immune checkpoint inhibitors: a single center cohort of sixty one patients","volume":"71","author":"Richter","year":"2019","journal-title":"Arthritis Rheumatol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1127","DOI":"10.1016\/j.semarthrit.2018.10.012","article-title":"Musculoskeletal rheumatic complications of immune checkpoint inhibitor therapy: a single center experience","volume":"48","author":"Mooradian","year":"2019","journal-title":"Semin Arthritis Rheum."},{"key":"B6","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1007\/s11926-019-0828-7","article-title":"Systemic vasculitis associated with immune check point inhibition: analysis and review","volume":"21","author":"Crout","year":"2019","journal-title":"Curr Rheumatol Rep."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1165","DOI":"10.1016\/j.jaad.2018.07.051","article-title":"Immune checkpoint inhibitors and the development of granulomatous reactions","volume":"81","author":"Cornejo","year":"2019","journal-title":"J Am Acad Dermatol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"866","DOI":"10.1002\/art.41604","article-title":"Inflammatory myositis in cancer patients receiving immune checkpoint inhibitors","volume":"73","author":"Aldrich","year":"2021","journal-title":"Arthritis Rheumatol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1056\/NEJMc0904283","article-title":"El, Knebelmann B. 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