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Successful Treatment of Arthritis Induced by Checkpoint Inhibitors with Tocilizumab: a Case Series

Kim ST, Tayar J, Trinh VA, Suarez-Almazor M, Garcia S, Hwu P, Johnson DH, Uemura M, Diab A. - Ann Rheum Dis 2017;76:2061-64. doi: 10.1136/annrheumdis-2017-211560

This case series evaluated the use of tocilizumab (TCZ) as an effective treatment for patients who develop arthritis as an adverse event (AE) of immune checkpoint inhibitor (ICI) cancer treatment. Results suggested that TCZ was an effective treatment, as it reduced the arthritis disease progression.
ICIs have been defined as a revolutionary treatment for metastatic melanomas; however, a common AE is the development of polyarthritis. Current arthritis treatments reduce the efficiency of ICI therapy or lead to the development of further AEs. TCZ has been highlighted as a potential treatment that could be given to these patients.
Three patients were identified who had been treated with ICIs for metastatic melanoma, and subsequently developed arthritis. All three were given biweekly treatments of TCZ, and continued ICI.
Following the TCZ treatment, all patients reported reductions in the number of swollen and tender joints as well as patient pain scores. Two patients had controlled arthritis by the end of the study, with one continuing and the other halting TCZ treatment. One patient was in remission by the end of the study and continued with TCZ treatment.
These data suggest that TCZ may be an effective treatment for patients who develop immune-related AEs whilst on ICI therapy. However due to the small number of cases, further research is needed to prove efficacy before this treatment can be chosen over current options.

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Upload date: December 2017

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