Rheumatologic immune checkpoint inhibitor-related adverse events

Curr Opin Rheumatol. 2023 May 1;35(3):141-148. doi: 10.1097/BOR.0000000000000935. Epub 2023 Mar 9.

Abstract

Purpose of review: Immune check point inhibitors (ICIs) are a unique class of cancer treatments that harness the body's innate antitumor response. Although these medications have transformed oncology care, they also lead to generalized immune activation that can result in toxicities across a spectrum of organ systems called immune-related adverse events. This article reviews the most common rheumatologic immune-related adverse events and their management.

Recent findings: Inflammatory arthritis, polymyalgia rheumatic, sicca symptoms, systemic sclerosis, myositis, and vasculitis have all been reported as ICI adverse events. Treatment includes nonsteroidal anti-inflammatory drugs, glucocorticoids, traditional DMARDs, and biologics.

Summary: Rheumatologists have an important role in the management of patients with rheumatologic immune-related adverse events. Working with our oncology colleagues, we can help manage rheumatologic immune-related adverse events while optimally preserving ICI's antitumor effects.

Publication types

  • Review

MeSH terms

  • Antirheumatic Agents* / adverse effects
  • Arthritis, Rheumatoid* / drug therapy
  • Humans
  • Immune Checkpoint Inhibitors / adverse effects
  • Myositis* / chemically induced
  • Myositis* / drug therapy
  • Neoplasms* / drug therapy
  • Vasculitis* / drug therapy

Substances

  • Immune Checkpoint Inhibitors
  • Antirheumatic Agents