Early Adalimumab Induction for Immune Checkpoint Inhibitor Associated Inflammatory Arthritis

Inclusion Criteria: * • Patients are deemed eligible for study participation if they meet all the following: * Adult patients (age 18 or older) * New (within the last 6 months prior to enrollment) inflammatory arthritis defined by any of the following at the time of screening (either on physical exam or by ultrasound) by a certified rheumatologist: * 1 or more swollen joints OR * 1 or more tenosynovitis OR * 1 or more enthesitis * Arthritis onset with taking ICI therapy OR within 4 weeks of stopping ICI therapy including CTLA-4, PD-1, and PDL-1 inhibitors * Initiation of ICI therapy must predate the onset of inflammatory arthritis * Glucocorticoid dependence at any time before enrolment, defined by either: * Patients requiring prednisone at a dose of at least 10 mg daily (or equivalent) OR * Patients for whom at least 1 glucocorticoid taper failed to control the disease activity * Negative tuberculosis (TB) status within the past 12 months (TB skin test or quantiferon) for the patients in the adalimumab group. If not available, the status should be confirmed within 6 months of enrollment in the study (adalimumab group only) * Written informed consent provided by patient or power of attorney Exclusion Criteria: * Patients are excluded if they meet any of the following: * Previous diagnosis of inflammatory arthritis or other rheumatic disease (prior to current acute episode) * Including but not limited to: rheumatoid arthritis, systemic lupus erythematosu…