Objective We sought to investigate the long-term outcomes of patients who develop immune checkpoint inhibitor (ICI)-induced inflammatory arthritis (IA), to define factors associated with IA persistence after ICI cessation, the need for immunosuppressants and the impact of these medications on underlying malignancies. Methods We conducted a prospective observational study of patients referred for IA associated with ICIs. Patients were recruited from June 2015 to December 2018. Information was obtained at the baseline visit, and follow-up visits occurred at varying intervals for up to 24 months from ICI cessation. Kaplan-Meier curves were developed to characterise IA persistence. Cox proportional hazards models were used to assess the influence of various factors on IA persistence. Logistic regression was used to evaluate the impact of IA treatment on tumour response. Results Sixty patients were monitored with a median follow-up after ICI cessation of 9 months. A majority (53.3%) had active IA at their most recent follow-up. IA was less likely to improve in those with longer duration of ICI use, in those receiving combination ICI therapy, and in patients with multiple other immune-related adverse events. Tumour response did not appear to be impacted by immunosuppression. Although not statistically significant, persistent IA was correlated with a better tumour response (complete or partial response). Conclusion ICI-induced IA can become a long-term disease necessitating management by rheumatology for immunomodulatory treatment. Importantly, the use of immunomodulatory treatment has not been shown to impact cancer outcomes in this study.

中文翻译：

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免疫检查点抑制剂诱导的炎症性关节炎在免疫治疗停止后仍然存在

目的 我们试图调查发生免疫检查点抑制剂 (ICI) 诱导的炎症性关节炎 (IA) 患者的长期结果，以确定与 ICI 停止后 IA 持续存在相关的因素、免疫抑制剂的需要以及这些药物对潜在的恶性肿瘤。方法 我们对因与 ICI 相关的 IA 而转诊的患者进行了前瞻性观察研究。患者招募时间为 2015 年 6 月至 2018 年 12 月。在基线访视时获得信息，并在 ICI 停止后长达 24 个月的不同时间间隔进行随访。开发了卡普兰-迈尔曲线来表征 IA 持久性。Cox 比例风险模型用于评估各种因素对 IA 持久性的影响。逻辑回归用于评估 IA 治疗对肿瘤反应的影响。结果 在 ICI 停止 9 个月后，对 60 名患者进行了中位随访监测。大多数 (53.3%) 在最近的随访中患有活动性 IA。在使用 ICI 时间较长的患者、接受联合 ICI 治疗的患者以及患有多种其他免疫相关不良事件的患者中，IA 不太可能得到改善。肿瘤反应似乎不受免疫抑制的影响。虽然没有统计学意义，但持续的 IA 与更好的肿瘤反应（完全或部分反应）相关。结论 ICI 诱发的 IA 可能成为一种长期疾病，需要通过风湿病学进行免疫调节治疗。重要的，