Immune-Related Adverse Effects of Cancer Immunotherapy- Implications for Rheumatology

Rheum Dis Clin North Am. 2017 Feb;43(1):65-78. doi: 10.1016/j.rdc.2016.09.007. Epub 2016 Oct 22.


Immune checkpoint inhibitors (ICIs) are increasingly studied and used as therapy for a growing number of malignancies. ICIs work by blocking inhibitory pathways of T-cell activation, leading to an immune response directed against tumors. Such nonspecific immunologic activation can lead to immune-related adverse events (IRAEs). Some IRAEs, including inflammatory arthritis, sicca syndrome, myositis, and vasculitis, are of special interest to rheumatologists. As use of ICIs increases, recognition of these IRAEs and developing treatment strategies will become important. In this review, the current literature on rheumatic and musculoskeletal IRAEs is summarized. The incidence, clinical presentations, and treatment considerations are highlighted.

Keywords: Arthritis; Immune checkpoint inhibitors; Immune-related adverse events; Malignancy; Sicca syndrome.

Publication types

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

MeSH terms

  • Arthritis / chemically induced*
  • Arthritis / immunology
  • Autoimmune Diseases / complications
  • Autoimmune Diseases / immunology*
  • Disease Progression
  • Humans
  • Immunotherapy / adverse effects*
  • Myositis / chemically induced*
  • Myositis / immunology
  • Neoplasms / complications
  • Neoplasms / drug therapy*
  • Rheumatology
  • Sjogren's Syndrome / chemically induced*
  • Sjogren's Syndrome / immunology
  • Vasculitis / chemically induced*
  • Vasculitis / immunology