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Response to: ‘Checkpoint inhibitors and arthritis: seeking balance between victories and defeats’ by Moura and Moura
  1. Thierry Schaeverbeke,
  2. Marie Kostine
  1. Department of Rheumatology, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
  1. Correspondence to Prof Thierry Schaeverbeke, Department of Rheumatology, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France; thierry.schaeverbeke{at}

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We appreciate the very clever analysis by Moura and Moura1 of the numerous questions addressed by the management of immune-related adverse events (irAEs) occurring in patients treated with checkpoint inhibitors, and their citation of a French proverb, although the exact meaning of the proverb « en médecine comme en amour, ni jamais ni toujours » is not that medicine is unpredictable, but that there are always exceptions. Medical doctors must be aware of these exceptions and constantly remain vigilant.

The two first questions addressed by Moura and Moura concern the value of a rheumatologist’s collaboration while guidelines have recently been published to help oncologists in the management of irAEs.2–4 We definitely agree with these authors to consider the strong value added by the rheumatologist’s analysis of musculoskeletal symptoms occurring in patients treated with immune checkpoint inhiboitors (ICIs). To illustrate this point, we will shortly report on three recent patients referred to our rheumatology unit by their oncologist for a suspicion of irAE.

The first patient, an 80-year-old woman, was given nivolumab since 5 …

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  • Handling editor Josef S Smolen

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.

  • Collaborators FHU-ACRONIM: Aquitaine’s Care And Research Organisation For Inflammatory And Immune-Mediated Diseases.

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