Clinical Drug Investigation

, Volume 39, Issue 12, pp 1251–1254 | Cite as

Nivolumab-Induced Recurrence of Rheumatoid Arthritis in a Patient with Metastatic Gastric Adenocarcinoma

  • Masataka NishikawaEmail author
  • Atsushi Goshima
  • Hajime Owaki
  • Takeshi Fuji
Research Letter

Advances in immunotherapy have dramatically transformed the prognosis of a number of cancers. Antibodies against the T cell surface protein programmed death-1 (PD-1) and its ligand PD-L1, expressed on tumor cells, are increasingly used to treat advanced malignancies [1]. Nivolumab, a human IgG4 monoclonal antibody with high affinity for PD-1, is the first PD-1-targeted immune checkpoint inhibitor (ICI) approved by the US Food and Drug Administration (FDA) [2].

A range of immune-related adverse events (IRAEs) have been described in patients treated with ICIs, which include multiple organ toxicities and disease exacerbation for patients with pre-existing autoimmune disease. Hypothyroidism, rash, diarrhea, and hepatitis are among the most common IRAEs, but their frequency varies with the specific drug and tumor type [3]. To date, rheumatic IRAEs associated with ICI use have not been widely recognized or well-characterized [4].

We describe recurrence of pre-existing rheumatoid arthritis...



We thank Anne M. O’Rourke, PhD, from Edanz Group ( for editing a draft of this manuscript.

Compliance with Ethical Standards


No funding was received for this letter.

Conflict of interest

Masataka Nishikawa, Atsushi Goshima, Hajime Owaki, and Takeshi Fuji have no conflicts of interest to declare.

Ethics approval

This letter was approved by the Ethics Committee of Japan Community Healthcare Organization Osaka Hospital.

Informed consent

Informed consent was obtained from the patient before his death.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of RheumatologyJapan Community Healthcare Organization Osaka HospitalOsaka CityJapan
  2. 2.Department of Orthopaedic SurgeryJapan Community Healthcare Organization Osaka HospitalOsaka CityJapan

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