Characteristics of 20 patients from three centres
Patient | Age/ Sex | Tumour type | Checkpoint inhibitor | Fulfilled EULAR/ACR classification criteria* | Unfulfilled criteria | Atypical features | Treatment |
Cleveland Clinic Foundation, Cleveland, Ohio, USA | |||||||
1 | 63 M | RCC | Nivolumab | No; five points | Acute phase reactants | Prednisone 40 mg; tocilizumab 162 mg q2 weeks | |
2 | 69 M | Melanoma | Ipilimumab/ nivolumab | Yes; six points | Sicca symptoms; antinuclear antibody 1:1280, anti-Sjogren’s-syndrome-related antigen A >8 IU | Prednisone 30 mg | |
3 | 79 M | Melanoma | Ipilimumab/ nivolumab | Yes; seven points† | Sicca symptoms | Prednisone 20 mg | |
4 | 57 M | Melanoma | Pembrolizumab | No; three points | Acute phase reactants; RF 35 IU/mL; knee involvement | Prednisone 60 mg | |
5 | 60 M | Melanoma | Pembrolizumab | No; three points | RF 45 IU/mL; knee involvement | Prednisone 60 mg | |
6 | 66 M | Melanoma | Nivolumab | Yes; five points | Hand involvement | Prednisone 20 mg; methotrexate | |
7 | 69 F | RCC | Nivolumab | Yes; five points | Hand involvement | Prednisone 10 mg; tocilizumab 162 mg q2 weeks | |
8 | 66 M | RCC | Durvalumab; tremilimumab | Yes; five points | Hand involvement | Prednisone 20 mg | |
9 | 72 F | RCC | Avelumab | Yes; four points | Acute phase reactants; hand and knee involvement | Prednisone 20 mg | |
Johns Hopkins University, Baltimore, Maryland, USA | |||||||
10 | 66 M | Lung adenocarcinoma | Pembrolizumab | No; six points | Shoulder aching | Prednisone 20 mg | |
11 | 63 F | Poorly differentiated carcinoma with squamous features | Durvalumab | Yes; six points | Prednisone 15 mg; hydroxychloroquine | ||
12 | 59 F | Melanoma | Nivolumab | Yes; six points | Prednisone 7.5 mg; bilateral trochanter injections | ||
13 | 76 M | Merkle cell carcinoma | Nivolumab | No; four points | |||
Centre Hospitalier Universitaire, Bordeaux, France | |||||||
14 | 81 M | Melanoma | Pembrolizumab | No; five points | Acute phase reactants; knee involvement | Prednisone 10 mg | |
15 | 74 M | Melanoma | Pembrolizumab | Yes; seven points† | Prednisone 15 mg | ||
16 | 59 M | Melanoma | Pembrolizumab | No; seven points†* | Acute phase reactants | Prednisone 10 mg | |
17 | 65 F | NSCLC | Nivolumab | No; seven points† | Acute phase reactants | Prednisone 15 mg | |
18 | 63 M | NSCLC | Nivolumab | Yes; six points | Resolved with NSAIDs alone | NSAIDs | |
19 | 74 M | RCC | Ipilimumab/ nivolumab | Yes; five points | Hand involvement | Prednisone 10 mg | |
20 | 77 F | Melanoma | Pembrolizumab | Yes; six points† | Hip pain | Prednisone 15 mg |
All patients had complete reporting to allow application of the EULAR/ACR classification criteria.
*A score of four or more is needed for PMR classification without ultrasound, and a score of five or more if ultrasound is included.
†Met ultrasound criteria.
ACR, American College of Rheumatology; EULAR, European League Against Rheumatism; NSAIDs, non-steroidal anti-inflammatory drugs; NSCLC, non-small cell lung cancer;PMR, polymyalgia rheumatica; RCC, renal cell carcinoma.