Evidence map›Paper›PMID 27307501›Full record

ArticleAnnals of the rheumatic diseases2017

Inflammatory arthritis and sicca syndrome induced by nivolumab and ipilimumab.

Laura C Cappelli, Anna Kristina Gutierrez, Alan N Baer, Jemima Albayda, Rebecca L Manno, Uzma Haque, Evan J Lipson, Karen B Bleich, Ami A Shah, Jarushka Naidoo and 3 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of the rheumatic diseases, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 192 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
192citing papers in PubMed, 12 pooled it
26.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

192 citing papers in PubMed, 12 syntheses or guidelines pooled it, 388 citations in OpenAlex.

  1. Pooled it
  2. Diagnosis and management of immune checkpoint inhibitor-induced dry mouth and salivary gland dysfunction in oncology patients: a systematic review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
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  14. The Immune Checkpoint Inhibitors Journey: From Early Promise to Lasting Impact.Journal of immunotherapy and precision oncology · 2026
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  19. Pain spectrum in immune checkpoint inhibitor-related adverse events: evolution, characteristics and management challenges based on bibliometrics.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Article
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132 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 1 institution in 1 country.

Laura C CappelliDivision of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Anna Kristina GutierrezDivision of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Alan N BaerDivision of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Jemima AlbaydaDivision of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Rebecca L MannoDivision of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Uzma HaqueDivision of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Evan J LipsonDepartment of Oncology, Johns Hopkins University, Baltimore, Maryland, USA.
Karen B BleichDepartment of Radiology, Johns Hopkins University, Baltimore, Maryland, USA.
Ami A ShahDivision of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Jarushka NaidooDepartment of Oncology, Johns Hopkins University, Baltimore, Maryland, USA.
Julie R BrahmerDepartment of Oncology, Johns Hopkins University, Baltimore, Maryland, USA.
Dung LeDepartment of Oncology, Johns Hopkins University, Baltimore, Maryland, USA.
Clifton O BinghamDivision of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Johns Hopkins University · US

Funding

Sample Processing and Immunoassay Research CoreP30AR070254 · NIAMS · JOHNS HOPKINS UNIVERSITY · PI Antony Rosen · 2016 to 2026
$8.9M
Phenotype-Specific Immune Responses in the Systemic VasculitidesP30AR053503 · NIAMS · JOHNS HOPKINS UNIVERSITY · PI SOLOSKI, MARK J · 2006 to 2015
$6.4M
Summer Research Training in Aging for Medical StudentsT35AG026758 · NIA · JOHNS HOPKINS UNIVERSITY · PI Stephanie Nothelle, Sevil Yasar · 2005 to 2026
$1.9M
Cancer, Autoantigens, and Scleroderma Investigating the ConnectionK23AR061439 · NIAMS · JOHNS HOPKINS UNIVERSITY · PI SHAH, AMI AALOK · 2012 to 2016
$699k
NIAMS NIH HHS K23 AR061439NIAMS NIH HHS P30 AR053503NIAMS NIH HHS P30 AR070254NIA NIH HHS T35 AG026758
6 · The paper itself

Abstract

objectivesImmune checkpoint inhibitors (ICIs) targeting the cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and programmed cell death protein 1 (PD-1) pathways have demonstrated survival improvements in multiple advanced cancers, but also cause immune-related adverse events (IRAEs). IRAEs with clinical features similar to rheumatic diseases have not been well described. We report patients with inflammatory arthritis and sicca syndrome secondary to ICIs.

methodsWe report patients evaluated in the Johns Hopkins Rheumatology clinics from 2012 to 2016 identified as having new rheumatological symptoms in the context of treatment with ipilimumab (anti-CTLA-4) and/or nivolumab (anti-PD-1) for solid tumours.

resultsWe identified 13 patients who received ICIs and developed rheumatological IRAEs. Mean age was 58.7 years. Cancer types included melanoma, non-small cell lung cancer, small cell lung cancer and renal cell carcinoma. ICI regimens included nivolumab or ipilimumab as monotherapy (n=5), or combination nivolumab and ipilimumab (n=8). Nine of 13 patients developed an inflammatory arthritis, 4 with synovitis confirmed on imaging (3 ultrasound, 1 MRI) and 4 with inflammatory synovial fluid. Four patients developed sicca syndrome with severe salivary hypofunction. Other IRAEs included: pneumonitis, colitis, interstitial nephritis and thyroiditis. Antinuclear antibodies were positive in 5 out of 13 patients. All 13 patients were treated with corticosteroids with varying response. Two patients were treated with methotrexate and antitumor necrosis factor therapy for inflammatory arthritis.

conclusionsAs ICIs are increasingly used for a range of malignancies, new cases of rheumatic IRAEs are likely to emerge. Further research is required to understand mechanisms, determine risk factors and develop management algorithms for rheumatic IRAEs.

Indexed as

AdultAgedAntibodies, AntinuclearAntibodies, MonoclonalAntineoplastic AgentsArthritisFemaleHumansIpilimumabMaleMiddle AgedNivolumabSjogren's SyndromeSynovitisAntibodies, AntinuclearAntibodies, MonoclonalAntineoplastic AgentsIpilimumabNivolumabArthritisAutoimmune DiseasesInflammationSjøgren's Syndrome

Identifiers

PMID27307501
PMCPMC5333990
OpenAlexW2441690768

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.