How would you approach management of a patient with checkpoint inhibitor induced psoriatic arthritis?

Pt with active skin and joint disease. Previously on Cemiplimab (PD-1) for squamous cell carcinoma of the skin. Do you avoid traditional DMARDs due to increased skin cancer risk?

Answer from: at Academic Institution

We will often try a short course of steroids if this is new psoriatic arthritis due to immune checkpoint inhibitor therapy. We then consider a DMARD like methotrexate or biologic. If biologics are needed, we will typically choose an IL-12/23 or IL-23 inhibitor or a TNF inhibitor.

Comments

at Cleveland Clinic
I agree with @Laura. For me, IL23 is the 1st line.

at Mainehealth
Same, often short course of steroids is enough.

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How would you approach management of a patient with checkpoint inhibitor induced psoriatic arthritis?

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