Understanding Inflammatory Arthritis in Cancer Patients Caused by Checkpoint Inhibitors

[ Music ]>>I have a clinical and a research interest in
inflammatory arthritis that develops as a result of immune checkpoint inhibitor
treatment of cancer. In patients who get immune checkpoint
inhibitors, about 5% will develop arthritis, actual inflammation in the joints, although,
closer to 14 or 15% will get joint pains.>>So, when I first started
seeing these patients, I thought we really need
more information about them. We need to get that information
out to the public. I thought it would be great to develop a
system where we keep track of these patients, we know what they’re going through, we
know what conditions they’re developing.>>So about a year and a half ago, we
established a registry so that we could, in a formal way, begin to collect
information about our patients.>>When we started this, we didn’t
even know how often does it happen, which joints does it affect? Does it respond to this treatment
or that treatment? So, we didn’t really have a good sense of that. Being able to collect a large
cohort or a registry of patients, which is what we have here, is really critical
to have the numbers to be able to generalize and begin to learn what does it look
like, what’s causing it, you know, what is the best way to treat it.>>If it’s a mild case, we might be able
to get away with a little bit of steroid. We have been using things like methotrexate, so
that the non biologic DMARDs have been useful, and then some– in severe cases, we will use
biologics, such as infliximab or tocilizumab.>>We know how to treat arthritis pretty well. Autoimmune arthritis, we have lots of
medicines available and we know well how to use those outside of the cancer setting, but if you’ve just given a cancer patient a
medication to stimulate their immune system, and then your treatment is
suppressing the immune system, you worry that you might be
interfering with the anticancer effects. So, trying to figure out what the best
treatments are that will control the arthritis without interfering with the anticancer
effects is really the holy grail. [ Music ]

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