Immune checkpoint inhibitor-induced inflammatory arthritis: identification and management. [Review]

MedStar author(s):
Citation: Expert Review of Clinical Immunology. 16(8):771-785, 2020 08.PMID: 32772596Institution: MedStar Georgetown University Hospital ResidentsForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Arthritis/ci [Chemically Induced] | *Immune Checkpoint Inhibitors/ae [Adverse Effects] | Arthritis/di [Diagnosis] | Arthritis/ep [Epidemiology] | Arthritis/th [Therapy] | Autoimmune Diseases/co [Complications] | Humans | Immune Checkpoint Inhibitors/pd [Pharmacology]Year: 2020ISSN:
  • 1744-666X
Name of journal: Expert review of clinical immunologyAbstract: AREAS COVERED: In this review, the authors focus on ICI-IIA. Relevant articles were identified through PubMed searches, spanning 2010 to the present. The authors detail the current understanding of its pathogenesis, diagnostic evaluation, and management strategies.EXPERT OPINION: ICI-IIA is a complex irAE that we are just beginning to understand mechanistically and pathologically. It often presents later in the disease course than other irAEs and, due to various reasons, is under-recognized. In some patients, ICI-IIA may become a chronic disease, which distinguishes it from most irAEs that resolve after ICI discontinuation. Multiple important questions still demand further research including which patients may develop ICI-IIA? What are possible diagnostic and prognostic markers? Do anti-arthritis therapies interfere with the anti-tumor response? and when should steroid-sparing agents be initiated? Close collaboration and shared decision-making between oncologists, rheumatologists, and the patient are essential when managing this particular irAE.INTRODUCTION: Immune checkpoint inhibitors (ICIs) have proved to be groundbreaking in the field of oncology. However, immune system overactivation from ICIs has introduced a novel medical entity known as immune-related adverse events (irAEs), that can affect any organ or tissue. ICI-induced inflammatory arthritis (ICI-IIA) is the most common musculoskeletal irAE and can lead to significant morbidity and limitation in anti-cancer therapy.All authors: Gupta S, Katz JD, Mollaeian A, Williams SGOriginally published: Expert Review of Clinical Immunology. :1-15, 2020 Aug 24Fiscal year: FY2021Digital Object Identifier: ORCID: Date added to catalog: 2020-09-02
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Journal Article MedStar Authors Catalog Article 32772596 Available 32772596

AREAS COVERED: In this review, the authors focus on ICI-IIA. Relevant articles were identified through PubMed searches, spanning 2010 to the present. The authors detail the current understanding of its pathogenesis, diagnostic evaluation, and management strategies.

EXPERT OPINION: ICI-IIA is a complex irAE that we are just beginning to understand mechanistically and pathologically. It often presents later in the disease course than other irAEs and, due to various reasons, is under-recognized. In some patients, ICI-IIA may become a chronic disease, which distinguishes it from most irAEs that resolve after ICI discontinuation. Multiple important questions still demand further research including which patients may develop ICI-IIA? What are possible diagnostic and prognostic markers? Do anti-arthritis therapies interfere with the anti-tumor response? and when should steroid-sparing agents be initiated? Close collaboration and shared decision-making between oncologists, rheumatologists, and the patient are essential when managing this particular irAE.

INTRODUCTION: Immune checkpoint inhibitors (ICIs) have proved to be groundbreaking in the field of oncology. However, immune system overactivation from ICIs has introduced a novel medical entity known as immune-related adverse events (irAEs), that can affect any organ or tissue. ICI-induced inflammatory arthritis (ICI-IIA) is the most common musculoskeletal irAE and can lead to significant morbidity and limitation in anti-cancer therapy.

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