Arthralgia – Grade 2

Management escalation pathway

• Escalate analgesia and use NSAID (if not contraindicated) or low dose corticoids (≤10mg prednisone)
• Benefits of corticoids may be reevaluated by a rheumatologist after 2 weeks; in case of doubt contact rheumatologist before
• Discuss witholding ICPi until resolution of pain (if corticoids are required, restart of ICPi should be discussed in a multidisciplinary team)

Assessment and Investigations

• Perform X-rays to assess inflammatory pathology, always consider other imaging to exclude possible metastasis
• Complete rheumatological history
• Examination of all joints and skin
• Consider ultrasound to exclude arthritis
• Autoimmune panel:
  – ACPA
  – RF
  – ANA (by indirect immunofluorescence) followed by more specific analysis if positive result (according to local practice)