RT Journal Article
SR Electronic
T1 Comparative safety and effectiveness of TNF inhibitors, IL6 inhibitors and methotrexate for the treatment of immune checkpoint inhibitor-associated arthritis
JF Annals of the Rheumatic Diseases
JO Ann Rheum Dis
FD BMJ Publishing Group Ltd and European League Against Rheumatism
SP 920
OP 926
DO 10.1136/ard-2023-223885
VO 82
IS 7
A1 Bass, Anne R
A1 Abdel-Wahab, Noha
A1 Reid, Pankti D
A1 Sparks, Jeffrey A
A1 Calabrese, Cassandra
A1 Jannat-Khah, Deanna P
A1 Ghosh, Nilasha
A1 Rajesh, Divya
A1 Aude, Carlos Andres
A1 Gedmintas, Lydia
A1 MacFarlane, Lindsey
A1 Arabelovic, Senada
A1 Falohun, Adewunmi
A1 Mushtaq, Komal
A1 Haj, Farah Al
A1 Diab, Adi
A1 Shah, Ami A
A1 Bingham, Clifton O
A1 Chan, Karmela Kim
A1 Cappelli, Laura C
YR 2023
UL http://ard.bmj.com/content/82/7/920.abstract
AB Objectives To compare the safety and effectiveness of biologic and conventional disease-modifying antirheumatic drugs (DMARDs) for immune checkpoint inhibitor-associated inflammatory arthritis (ICI-IA).Methods The retrospective multicentre observational study included patients with a diagnosis of ICI-IA treated with a tumour necrosis factor inhibitor (TNFi), interleukin-6 receptor inhibitor (IL6Ri) and/or methotrexate (MTX); patients with pre-existing autoimmune disease were excluded. The primary outcome was time to cancer progression from ICI initiation; the secondary outcome was time to arthritis control from DMARD initiation. Cox proportional hazard models were used to compare medication groups, adjusting for confounders.Results 147 patients were included (mean age 60.3 (SD 11.9) years, 66 (45%) women). ICI-IA treatment was TNFi in 33 (22%), IL6Ri 42 (29%) and MTX 72 (49%). After adjustment for time from ICI initiation to DMARD initiation, time to cancer progression was significantly shorter for TNFi compared with MTX (HR 3.27 (95% CI 1.21 to 8.84, p=0.019)) while the result for IL6Ri was HR 2.37 (95% CI 0.94 to 5.98, p=0.055). Time to arthritis control was faster for TNFi compared with MTX (HR 1.91 (95% CI 1.06 to 3.45, p=0.032)) while the result for IL6Ri was HR 1.66 (95% CI 0.93 to 2.97, p=0.089). A subset analysis in patients with melanoma gave similar results for both cancer progression and arthritis control.Conclusion The treatment of ICI-IA with a biologic DMARD is associated with more rapid arthritis control than with MTX, but may be associated with a shorter time to cancer progression.No data are available. All data relevant to the study are included in the article or uploaded as an online supplemental information.