However, this risk does not appear unacceptably high and therefore exclusion of RA patients from immunotherapy does not appear justified.14–16 Patients with RA with low disease activity and not requiring high doses of immunosuppressants may carry a lower risk.15,16,22 Anti-PD1 agents are more highly recommended for patients with RA since they are considered to exhibit a lower grade of toxicity compared to anti-CTLA4.15 Close monitoring of these patients is of importance for early diagnosis and treatment of potential irAEs. Here, CTLA4 is linked to rheumatoid arthritis.