Comparison of immune checkpoint inhibitor-induced arthritis and reactive arthritis to inform therapeutic strategy: review

Introduction - Immune checkpoint inhibitor-induced inflammatory arthritis (ICI-IA) is a relatively new disease entity caused by ICI agents during cancer therapy. Reactive arthritis (ReA) is a well-known disease entity caused by urogenital or gastrointestinal bacterial infection or pneumonia. In this...

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Main Authors: Jensen, Anders Kirkegaard (Author) , Chatzidionysiou, Katerina (Author) , Torp, Christopher Kirkegaard (Author) , Sørensen, Anne Sofie (Author) , Tenstad, Helene Broch (Author) , Schäfer, Valentin S. (Author) , Kostine, Marie (Author) , Jacobsen, Søren (Author) , Leipe, Jan (Author) , Kragstrup, Tue Wenzel (Author)
Format: Article (Journal)
Language:English
Published: April 2022
In: Biomedicine & pharmacotherapy
Year: 2022, Volume: 148, Pages: 1-9
ISSN:1950-6007
DOI:10.1016/j.biopha.2022.112687
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.biopha.2022.112687
Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S0753332222000750
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Author Notes:Anders Kirkegaard Jensen, Katerina Chatzidionysiou, Christopher Kirkegaard Torp, Anne Sofie Sørensen, Helene Broch Tenstad, Valentin S. Schäfer, Marie Kostine, Søren Jacobsen, Jan Leipe, Tue Wenzel Kragstrup

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520 |a Introduction - Immune checkpoint inhibitor-induced inflammatory arthritis (ICI-IA) is a relatively new disease entity caused by ICI agents during cancer therapy. Reactive arthritis (ReA) is a well-known disease entity caused by urogenital or gastrointestinal bacterial infection or pneumonia. In this sense, ICI-IA and ReA are both defined by a reaction to a well-specified causal event. As a result, comparing these diseases may help to determine therapeutic strategies. - Methods - We compared ICI-IA and ReA with special focus on pharmacological management. Specifically regarding treatment, we conducted a literature search of studies published in the PubMed database. Inclusion criteria were studies on treatment with non-steroidal anti-inflammatory drugs (NSAIDs), glucocorticoids (GC), or disease modifying antirheumatic drugs (DMARDs) in ICI-IA or ReA. During systematic selection, 21 studies evaluating ICI-IA and 14 studies evaluating ReA were included. - Results - In ICI-IA, prospective and retrospective studies have shown effects of non-steroidal anti-inflammatory drugs (NSAIDs), glucocorticoid (GC), sulfasalazine (SSZ), methotrexate (MTX), hydroxychloroquine (HCQ) and TNFi. In ReA, retrospective studies evaluated NSAIDs and GC. A randomized controlled trial reported the effect of SSZ, and a retrospective study reported the effect of MTX and SSZ in combination with tumor necrosis factor alpha inhibition (TNFi). For both entities, small case reports show treatment effects of interleukin 6 receptor inhibition (IL-6Ri). - Discussion - This literature review identified both similarities and differences regarding the pathogenesis and clinical features of ReA and ICI-IA. Studies on treatment reported effectiveness of NSAIDs, GC, MTX, SSZ and TNFi in both diseases. Further, small case reports showed effects of IL-6Ri. 
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