Table 2.
Flare rates and new irAEs according to PAD type, treatment and disease activity
| Characteristics | PAD flares | New irAEs | ||
|---|---|---|---|---|
| Grade 1–2 | Grade 3–4 | Grade 1–2 | Grade 3–4 | |
| Rheumatic PAD | ||||
| Rheumatoid arthritis (n = 8) | 4 (50%) | 0 | 2 (25%) | 0 |
| No therapy; remission, RF-/CCP-, non-erosive (n = 1) | 1; 8 m | 0 | ||
| MTX/HCQ continued; remission, erosive (n = 1) | 0 | 0 | ||
| HCQ continued, MTX added for flare; RF-/CCP-, non-erosive (n = 1) | 0 | 0 | ||
| MTX/HCQ stopped for cancer treatment (-4 m); LDA, RF + /CCP + , diagnosed since 3y (n = 1) | 0 | 1; PMR/colitis, < 1 m | ||
| MTX/HCQ stopped at cancer diagnosis (-9 m); remission, RF + /CCP + , non-erosive (n = 1) | 0 | 0 | ||
| MTX stopped at cancer diagnosis (-8 m), resumed 1 m pre-ICI; remission × 5 years, RF + /CCP + , non-erosive (n = 1) | 1; < 1 m | 1; colitis, 14 m | ||
| Tocilizumab stopped at cancer diagnosis (-4y), MTX continued, HCQ/SSZ added 1 m pre-ICI; LDA, RF + , erosive, longstanding disease (33y) (n = 1) | 1; < 1 m | 0 | ||
| Adalimumab stopped at cancer diagnosis (-3y), MTX continued; LDA, RF + , erosive, longstanding disease (23y) (n = 1) | 1; < 1 m | 0 | ||
| Psoriatic arthritis / peripheral SpA (n = 4) | 3 (75%) | 0 | 1 (25%) | 1 (25%) |
| No therapy; LDA (n = 1) | 1; < 1 m | 1; hepatitis, colitis, 4 m | 0 | |
| MTX stopped at cancer diagnosis (-1 m); LDA (n = 1) | 0 | 0 | 0 | |
| MTX stopped at cancer diagnosis (-3y), HCQ/SSZ continued; remission (n = 1) | No flare on Pembro; flare at < 1 m on Ipi | 0 | 0 | |
| Apremilast stopped within 1 week of ICI initiation, SSZ/Prednisone 5 mg continued; high disease activity (n = 1) | 1; < 1 m (after stopping Apremilast) | 0 | 1; hepatitis, < 1 m (before stopping Apremilast) | |
| Axial spondyloarthritis (n = 3): NSAID continued; inactive/LDA | 0 | 0 | 1 (33%); polyarthritis, < 1 m | 1 (33%); polyarthritis, 8 m |
| SLE (n = 2): HCQ continued; remission | 0 | 0 | 0 | 0 |
| PMR (n = 1): HCQ continued; remission | 1; < 1 m | 0 | 0 | 0 |
| Dermatomyositis (n = 1): no therapy; remission | 0 | 0 | 0 | 1; neutropenia, 1 m |
| Non-rheumatic PAD | ||||
| Psoriasis (n = 7) | 4 (57%) | 2 (29%) | 3 (43%) | 1 (14%) |
| No therapy; remission/LDA (n = 3) | 3; < 1 m | 0 | 1 polyarthritis, 1 m; 1 hepatitis, colitis, 4 m | 1; polyarthritis, tenosynovitis, < 1 m |
| Topical therapy; stable severe psoriasis (n = 1) | 0 | 1; 4 m | 1; arthritis, sacroiliitis, 4 m | 0 |
| MTX stopped at cancer diagnosis (-3y); remission (n = 1) | 0 | 0 | 0 | 0 |
| MTX stopped at cancer diagnosis (-1 m); flare (n = 1) | 1; 3 m | 0 | 0 | 0 |
| Ustekinumab/MTX stopped after cancer diagnosis (-6 m), apremilast continued; stable erythrodermic psoriasis (n = 1) | 0 | 1; 2 m | 0 | 0 |
| Inflammatory bowel disease (n = 4) | 0 | 1 (25%) | 1 (25%) | 2 (50%) |
| No therapy, remission (n = 1) (+ celiac) | 0 | 0 | 1; polyarthritis, mucositis, < 1 m | 0 |
| 5-aminosalicylic acid continued, remission (n = 2) (+ psoriasis) (+ dermatomyositis) | 0 | 0 | 0 | 1 polyarthritis, tenosynovitis, < 1 m; 1 neutropenia, 1 m |
| Ustekinumab/MTX stopped after cancer dx (-6 m) (n = 1) (+ psoriasis) | 0 | 1; 2 m | 0 | 0 |
| Interstitial pneumonia with autoimmune features (n = 1); no therapy, new diagnosis | 1; 2 m | 0 | 1; sicca, 2 m | 0 |
| Cutaneous lupus (n = 1); no therapy, remission | 0 | 0 | 0 | 1; polyarthritis-tenosynovitis, 1 m |
| Graves' disease (n = 1); no therapy, remission | 0 | 0 | 1; acral vasculitis, myositis, < 1 m | 0 |
CCP cyclic citrullinated peptide; HCQ hydroxychloroquine; Ipi ipilimumab; irAE immune-related adverse event; LDA low disease activity; m month(s) from ICI initiation; MTX methotrexate; NSAID non-steroidal anti-inflammatory drug; PAD preexisting autoimmune disease; Pembro pembrolizumab; PMR polymyalgia rheumatica; RF rheumatoid factor; SLE systemic lupus erythematosus; SSZ sulfasalazine; y year(s) from ICI initiation