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Review
. 2024 May;50(2):269-279.
doi: 10.1016/j.rdc.2024.02.002. Epub 2024 Mar 8.

Immune Checkpoint Inhibitor-induced Inflammatory Arthritis: Current Approaches to Management

Namrata Singh  1 , Anupama Shahane  2 , Jeffrey A Sparks  3 , Samuel Bitoun  4 , Laura C Cappelli  5
Affiliations
Review

Immune Checkpoint Inhibitor-induced Inflammatory Arthritis: Current Approaches to Management

Namrata Singh et al. Rheum Dis Clin North Am. 2024 May.

Abstract

The introduction of immune checkpoint inhibitors (ICIs) has changed the landscape of the treatment of cancer. Several immune-related adverse events (irAEs) have now been described such as ICI-inflammatory arthritis (IA), sicca syndrome, polymyalgia rheumatica, myositis, and vasculitis as a consequence of immune activation. The onset of the ICI-IA can vary from after the first infusion of ICIs to a delayed presentation a year or more after ICI initiation. Ultimately, baseline patient and tumor characteristics, the types of immunotherapies used, pre-existing autoimmune diseases, and/or other irAEs, as well as patient preferences will all shape the discussions around ICI-IA management.

Keywords: Biologics; Disease-modifying antirheumatic drugs; Immune checkpoint inhibitors; Inflammatory arthritis.

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Conflict of interest statement

Disclosure Dr N. Singh has no conflict of interest (COI) to report. Dr A. Shahane has no COI to report. Dr L.C. Cappelli has received research funding from Bristol-Myers Squibb and performed consulting for Bristol-Myers Squibb, Mallinckrodt, and Amgen. Dr J.A. Sparks has received research support from Bristol-Myers Squibb and performed consultancy for AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Gilead, Inova Diagnostics, Janssen, Optum, Pfizer, and ReCor unrelated to this work. The funders had no role in the decision to publish or preparation of this article. The content is solely the responsibility of the authors and does not necessarily represent the official views of Harvard University, its affiliated academic health care centers, or the National Institutes of Health.

Figures

Figure 1:
Figure 1:
Flow diagram indicating the approach to management when seeing a patient with question of ICI-IA in the clinic.
Figure 2:
Figure 2:
Images showing various features that can be observed in ICI-IA on musculoskeletal ultrasound (courtesy of Dr. Jemima Albayda). Extensor tenosynovitis (▲) and synovitis (★) in a wrist on A) long view and B) transverse view C) Large effusion at a knee D) Enthesophytes at the quadriceps tendon (arrow)
Figure 2:
Figure 2:
Images showing various features that can be observed in ICI-IA on musculoskeletal ultrasound (courtesy of Dr. Jemima Albayda). Extensor tenosynovitis (▲) and synovitis (★) in a wrist on A) long view and B) transverse view C) Large effusion at a knee D) Enthesophytes at the quadriceps tendon (arrow)
See this image and copyright information in PMC

References

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