Pakistan Journal of Pharmaceutical Sciences

Abstract: Rheumatoid arthritis (RA) is chronic autoimmune disorder leading to joint damage and systemic complications. This study aimed to explore the clinical effectiveness of combining immune checkpoint inhibitors (ICIs) with conventional disease-modifying antirheumatic drugs (DMARDs) in patients diagnosed with RA. A total of 50 patients undergoing cancer treatment with ICIs were enrolled in this observational study. Demographic and clinical data were collected. Patients receiving ICI therapy were concomitantly managed with conventional DMARDs, with treatment initiation and duration recorded. Response to therapy was assessed over a follow-up period of 60 days using clinical improvement scores. The mean age of the patients was 59.5 years, with males comprising 56% and smoking history comprising 62% of patients. Melanoma (36%) and renal carcinoma (30%) were the most common malignancies. Most patients were in stage III cancer, with 16% showing brain metastases. Grade 3 arthritis was present in 42% of the cohort. Kaplan-Meier survival estimates showed time to arthritis control within 60 days of DMARD initiation. Clinical improvement was observed in 62% of patients. RA patients treated with ICIs appears immune-related adverse events. Conventional DMARDs may contribute to manage inflammatory arthritis without significantly compromising cancer control. Further studies are needed to establish optimal treatment protocols.