Table 2

Characteristics of patients with arthritis treated with tocilizumab

Baseline patient characteristics (arthritis)Characteristics of the patients' arthritis treated with tocilizumab
Patient IDSex, AgeCancer, stage
Treatment (doses)
BORICI-statusOther IrAEs than arthritis
(CTCAE)
Duration≥1 CTCAE grade before inclusionShifted from GCsCTCAE grade, week 0CTCAE grade, week 8CTCAE grade, week 24Supportive, “as needed”Systemic GCs within 24 weeksResponse to TCZ
ArthralgiaArthritisMyalgiaArthralgiaArthritisMyalgiaArthralgiaArthritisMyalgia
A3M 76 yearsNSCLC, IV Pembro 2 mg/kg (15)SDOngoingNoneNew-onset, 3 daysNo332↑NE↑NENENENENEArthrocentesis, GCs and lidocaine IA in both knees, 2 times in Week 1–3, paracetamol, tramadolYes. Worsening of arthritis during ICIs on Day 24, started prednisoloneNo
A4M 77 yearsCutaneous
SCC, IV
Pembro 2 mg/kg (9)
CRPermanently discontinuedColitis (1), hypothyroidism (2)Chronic, 90 daysNo222↔2↔2↔2↓↓00↓↓0Paracetamol, ibuprofenNoYes
A5M 62 yearsNSCLC, III
Ipi1mg/kg+Nivo 3 mg/kg (4+10)
SDOngoingNoneNew-onset, 12 daysNo330↓↓0↓↓00↓↓0↓↓00Ibuprofen, local intra-articular injection in one knee between in week 3Yes. ICI-induced hypophysitisYes
A6F 60 yearsNSCLC, IV Pembro 2 mg/kg (26)SDOngoingPsoriasis (2)New-onset, 12 daysNo220↓↓0↓10↓↓0↓↓00Paracetamol, tramadolNoYes
A7F 67 yearsNSCLC, IV Pembro 2 mg/kg (12)PROngoingHypothyroidism (2), rash (1)Chronic, 12 daysNo221↓↓0↓1↓↓0↓↓0↓↓0↓↓0ParacetamolNoYes
A10F 62 yearsNSCLC, III Pembro 2 mg/kg (10)PROngoingHepatitis (1)New-onset, 15 daysNo220↓1↓10↓↓0↓↓00GCs IA in both knees in Week 2, paracetamolNoYes
A11F 30 yearsMelanoma, III Nivo 480 mg, adj (3)NEOngoingNoneNew-onset, 71 daysYes221↓↓0↓↓0↓↓000↔1Diclofenac, tramadolYes. ICI-induced hypophysitis and non-specific irAEsYes
A13F 65 yearsMelanoma, IV Pembro 2 mg/kg (28)PRPermanently discontinuedNoneChronic, 752 daysYes, steroid-dependent221↓10↔1↓10↔1Stopped regular GCs IANoYes
A16M 55 yearsMelanoma, IV Nivo 480 mg (33)CROngoingDiarrhea (1)New-onset, 85 daysNo220↓100NENENEParacetamolYes. Switch to prednisolone due to colds and risk factors for COVID-19Yes
AC12M 72 yearsNSCLC, IV Pembro 2 mg/kg (33)PRPermanently discontinuedRash (1)Chronic, 922 daysYes, steroid-dependent221↓1↓11↓1↓11NoneNoYes
AC20F 60 yearsOcular melanoma, IV Pembro 2 mg/kg*SDRestartedHypophysitis (2), pneumonitis (2)Chronic, 506 daysYes, steroid-dependent220↔2↔20↓100Continued regular arthrocentesis and GCs IA to Week 9, stopped due to response to toci. Paracetamol, ibuprofen, and tramadolNoYes
  • The arrows indicate the following: ↔, stable/no change; ↑ or ↓, increase or decrease of CTCAE grade ≥1; and ↓↓complete remission of symptoms. Some patients were not evaluable owing to initiation of non-ICI therapy or treatment with systemic glucocorticoids for colitis or arthritis. Definition of new-onset irAEs, debut of irAEs within <90 days; chronic irAEs, debut for more than ≥90 days ago. Arthritis was graded as grade 1, mild pain with inflammation, erythema, or joint swelling; grade 2, moderate pain associated with signs of inflammation, erythema, or joint swelling limiting instrumental activities of daily living; grade 3, severe pain associated with signs of inflammation, erythema, or joint swelling, irreversible joint damage, limiting self-care activities of daily living. Arthralgia and myalgia are graded from 1 to 3 on CTCAE V.5.0 (grade 1, mild pain; grade 2, moderate pain, limiting instrumental activities of daily living; grade 3, severe pain-limiting self-care activities of daily living).

  • *Previous treatment with ipilimumab (3 mg/kg) plus nivolumab (1 mg/kg).

  • †Management of irAE prior to screening: A4 received prednisolone 25 mg for diarrhea and levothyroxine for hypothyroidism. A6 received topical GCs for psoriasis. A7 received topical GCs for rash and levothyroxine for hypothyroidism. A11 received prednisolone 25 mg (12 days) for arthritis. A13 received prednisolone 3.75-25 mg (710 days) and regular methylprednisolone IA (bimonthly) for arthritis. A16 received prednisolone 5-25 mg for diarrhea. AC12 received prednisolone 10-25 mg (922 days) for arthritis. AC20 received prednisolone 2.5-250 mg (680 days for arthritis), hydrocortisone 30 mg (62 days for hypophysitis), betamethasone IA for arthritis, infliximab (2 doses, given 2 years prior to inclusion for colitis). All others received no treatment for irAE.

  • AC, arthritis and colitis; BOR, best overall response; C, colitis; CR, complete response; CTCAE, Common Terminology Criteria for Adverse Events; F, female; GCs, glucocorticoids; IA, intra-articular; ICIs, immune checkpoint inhibitors; Ipi, ipilimumab; irAE, immune-related adverse events; M, male; NE, not evaluable; Nivo, nivolumab; NSCLC, non-small cell lung cancer; Pembro, pembrolizumab; PR, partial response; SCC, squamous cell carcinoma; SD, stable disease; TCZ, tocilizumab.