The Association of Osteoarthritis With De Novo Inflammatory Arthritis in Patients Receiving Immune Checkpoint Inhibitors: A Retrospective Study

OBJECTIVE: We aim to identify risk factors to enable stratification of patients' susceptibility to inflammatory arthritis immune-related adverse events (IA-irAEs). This retrospective study mainly examines whether preexisting osteoarthritis (OA) increases the likelihood of de novo IA-irAEs. METHODS: The prevalence of OA among immune checkpoint inhibitor (ICI)-treated patients who developed IA-irAE, those who developed other types of irAEs but not IA (non-IA irAEs), and those who did not develop any irAEs (non-irAEs) were compared. Electronic medical records were reviewed to extract demographic, clinical, and laboratory data. Group comparisons and logistic regression analyses were performed. RESULTS: A total of 181 de novo IA-irAE patients, 140 non-IA irAE patients, and 170 non-irAE patients were included. The prevalence of OA was significantly higher in the IA-irAE group (69%) than in the non-IA irAE group (48%) and the non-irAE group (48%) (both P < 0.001). The IA-irAE group demonstrated a higher frequency of multisite OA, with more predominant hand involvement (62%) than the non-IA irAE with OA group (13%) and the non-irAE with OA group (13%) (both P < 0.001). A family history of autoimmune disease (AID) (odds ratio [OR] 2.03, 95% confidence interval [CI] 1.02-4.05), preexisting OA (OR 2.88, 95% CI 1.85-4.52), and melanoma (OR 2.63, 95% CI 1.56-4.47) were identified as risk factors for the development of IA-irAE. CONCLUSION: OA was more prevalent among ICI-treated patients developing IA-irAE than those who were not. Hand OA was the most common OA pattern in IA-irAE patients. Preexisting OA, melanoma, and a family history of AID were associated with IA-irAE.