Clinical characteristics of rheumatic syndromes associated with checkpoint inhibitors therapy

Rheumatology (Oxford). 2019 Dec 1;58(Suppl 7):vii68-vii74. doi: 10.1093/rheumatology/kez295.

Abstract

Compared with conventional cancer therapies, the spectrum of toxicities observed with checkpoint inhibitors is unique and can affect any organ system. Arthralgia and myalgia were by far the most commonly reported rheumatic immune-related adverse events in clinical trials, and there is now a growing number of case series and reports describing clinical features of de novo rheumatic immune-related adverse events, which will be the focus of this review. Some patients develop genuine classic rheumatic and musculoskeletal diseases, but a number of rheumatic immune-related adverse events mimic rheumatic and musculoskeletal diseases with atypical features, mainly polymyalgia rheumatica, rheumatoid arthritis and myositis, as well as several systemic conditions, including sicca syndrome, vasculitis, sarcoidosis, systemic sclerosis and lupus.

Keywords: checkpoint inhibitors; immune-related adverse events; rheumatic and musculoskeletal diseases.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antineoplastic Agents, Immunological / adverse effects*
  • Antineoplastic Agents, Immunological / therapeutic use
  • Arthritis, Rheumatoid / chemically induced
  • Arthritis, Rheumatoid / diagnosis
  • Diagnosis, Differential
  • Humans
  • Immunologic Factors / adverse effects
  • Immunologic Factors / therapeutic use
  • Immunotherapy / adverse effects*
  • Immunotherapy / methods
  • Myositis / chemically induced
  • Myositis / diagnosis
  • Neoplasm Metastasis
  • Neoplasms / drug therapy*
  • Polymyalgia Rheumatica / chemically induced
  • Polymyalgia Rheumatica / diagnosis
  • Rheumatic Diseases / chemically induced*
  • Rheumatic Diseases / diagnosis
  • Sjogren's Syndrome / chemically induced
  • Sjogren's Syndrome / diagnosis
  • Vasculitis / chemically induced
  • Vasculitis / diagnosis

Substances

  • Antineoplastic Agents, Immunological
  • Immunologic Factors