Immune checkpoint inhibitor–induced arthralgia is tightly associated with improved overall survival in cancer patients
Authors' conclusion
If arthralgia develops after ICIs, another irAE, such as relative adrenal insufficiency, may have developed. The incidence of arthralgia was associated with better OS
Study context
- Population
- Cancer patients treated with immune checkpoint inhibitors (ICIs): Randomized controlled trials (RCTs) from four online databases and the Yokohama City University (YCU) registry
- Participants
- 14,377 patients24 RCTs
- Comparison
- ICI-induced arthralgia vs no arthralgia
- ICI-induced arthralgian = 50
- Outcome
- ICI-induced arthralgia and its association with OS
Methodological detailsrandom-effects model, individual patient data reconstruction, retrospective registry (Yokohama City University)
- Random-effects model
- Individual patient data reconstruction
- Retrospective registry (Yokohama City University)
Pooled result
As reported in the abstract
OS, ICI-induced arthralgia vs no arthralgia
Overall survival (OS) validated in RCT patients with matched cancer types, drugs and time to arthralgia onset (with vs without ICI-induced arthralgia): HR (95% CI 0.17, 0.65), P < 0.001
0.34
Further pooled results
- Incidence of ICI-induced arthralgia (YCU registry)
- 13.6% · 50
- Incidence of ICI-induced arthralgia (YCU registry): of 369 patients
ICI-induced arthralgia (meta-analysis of RCTs)
- OR of ICI-induced arthralgia
- 1.37 (95% CI 1.20, 1.56)
Safety
| Outcome | OR (95% CI) | |
|---|---|---|
| Other grade ≥2 irAEs in patients with ICI-induced arthralgia (YCU registry)30 of 50 with arthralgia had other grade ≥2 irAEs | 1.92 (1.04–3.52) | |
| 0.20.5125Odds ratio (log scale) |
- Other grade ≥2 immune-related adverse event (irAEs) in patients with ICI-induced arthralgia (YCU registry) — By irAE type, significant difference for relative adrenal insufficiency: OR
- 3.88 (95% CI 1.80, 8.39)
ICI-induced arthralgia
- OR of ICI-induced arthralgia, random-effects meta-analysis of 24 RCTs
- 1.37 (95% CI 1.20, 1.56)
- Patients in YCU registry who developed ICI-induced arthralgia: 50 of 369
- 13.6%
Original publication
Immune checkpoint inhibitor–induced arthralgia is tightly associated with improved overall survival in cancer patients. Rheumatology (Oxford). Published 7 September 2022. doi:10.
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