EDISCIENCES

ABSTRACT

This case series was written to describe the clinical presentation and treatment of patients with inflammatory arthritis that occurred while on immunotherapy. In this retrospective case series, six patients with malignant melanoma were studied. All patients were on immunotherapy at the time of presentation with an inflammatory arthropathy. Immunotherapy agents included pembrolizumab, nivolumab, and dabrafenib/ trametinib. All patients presented with pain and swelling of the affected joint and had at least one knee affected. The patients received either oral or intraarticular steroids with some degree of symptomatic improvement. Five of six patients underwent intra- articular Corticosteroid Injection (CSI). One patient declined steroid injection and continued to monitor his symptoms as he had recently finished a course of oral steroids. In patients with malignant melanoma on immunotherapy, inflammatory arthritis can appear during treatment or after treatment has stopped. Rheumatologic agents were not started due to the concern for immune suppression and risk of reactivation of malignancy. Immuno-therapy related inflammatory arthritis can be difficult to treat, and treatment has often involved high-dose oral steroid tapers. Overall, there is a lack of literature and treatment protocol for those with inflammatory arthritis while on immunotherapy, and more research will need to be done in this area.