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Abstract
Pembrolizumab, a monoclonal antibody against the immune checkpoint receptor-programmed cell death protein 1, has proven clinical efficacy in melanoma and other solid tumors. It increases the body’s immune response against the tumor cells. However, because of an uninhibited immune system, immune-mediated adverse effects can arise. Though most adverse effects from pembrolizumab involve the gastrointestinal tract, skin, and endocrine system, rheumatologic manifestations are not very well defined. We describe two cases of severe inflammatory arthritis and tenosynovitis, which are rare adverse effects of pembrolizumab. Increased awareness of this manifestation is imperative to establish the diagnosis and initiate timely treatment.
Keywords:
Immune checkpoint inhibition with an anti-programmed cell death protein 1 (PD-1) antibody such as pembrolizumab has improved outcomes in advanced melanoma and non-small cell lung cancer.1 Although clinical trials have documented its impressive efficacy, unwanted immune-related adverse effects (AEs), resembling autoimmune diseases, have emerged and are generating widespread interest in the medical community. These immune-related AEs typically involve the skin, intestines, and endocrine system.2 Herein, we describe two cases...