Arthritis in cancer patients treated with immunotherapy

As any other therapy, immunotherapy may be expected to have some consequences in long-term. But, what to expect when it is a new possible disease such as arthritis? There is the possibility that patients may develop the disease and it is better to be prepared and be completely aware of that.

An article published by Smith and Bass in 2017, showed that a small sample of patients treated for a malignancy with immune checkpoint inhibitors targeting PD-1 (Nivolumab, pembrolizumab), PDL.1 (durvalumab) and/or CTLA-4 (Ipilimumab, tremelimumab) developed several musculoskeletal pathologies such as: Inflammatory polyarthritis, oligoarthritis and tenosynovitis. Also, all have in common that they were treated with systemic corticosteroids, but only 6 of 10 required <20 mg per day of prednisone.

Musculoskeletal immune-related adverse events can manifest as a rheumatoid arthritis–like polyarthritis, oligoarthritis, tenosynovitis, or polymyalgia rheumatica. Musculoskeletal symptoms can last more than a year, but they can generally be managed with low to moderate doses of corticosteroids.

This represents good news because generally cancer is an aggressive disease that depending on the stage that is detected, doctors could recommend the most aggressive therapies such as chemotherapies. But in recent years, immunotherapy represents a viable therapy that has shown to eliminate tumors and to have a good response to the disease, and since it doesn’t generate vomiting or discomfort as chemotherapy, it is the most preferable option for patients.

Here in Althian we have several protocols that used the therapies mentioned in the first paragraphs. We have plenty experience in the cancer field and we are aware the importance that has the correct control of adverse events. Please contact us and we will more than happy to talk to you about our common practices.