ICIs Can Trigger Rheumatic Symptoms Among Patients With Cancer
Immune checkpoint inhibitors (ICIs) can often trigger inflammatory syndromes and immune‐related adverse events (IRAEs) in patients with cancer, new research has shown.
Clinicians witness numerous rheumatic IRAEs reports, including inflammatory arthritis, myositis, and polymyalgia rheumatica. Myasthenia gravis or myocarditis may present among patients with myositis caused by ICIs.
“For patients who present with musculoskeletal symptoms while receiving ICI therapy, it is important to have an algorithm for evaluation,” the authors reported. “The differential diagnosis includes a range of musculoskeletal syndromes, such as crystalline arthritis, mechanical issues, and osteoarthritis, in addition to IRAEs. After diagnosing a rheumatic IRAE, rheumatologists must work with the patient and the oncologist to form a treatment plan.”
“Glucocorticoids and withholding the ICI are usually required to treat myositis; some patients with severe myositis require intravenous immunoglobulin or plasmapheresis. Further research is needed to optimize treatment of IRAEs that does not compromise the antitumor effect of ICIs,” the authors concluded.
--Angelique Platas
Reference:
Cappelli LC, Bingham CO. Expert perspective: immune checkpoint inhibitors and rheumatologic complications. Arthritis Rheum 2021;73(4):553-565