Immune checkpoint inhibitor-induced inflammatory arthritis

Benjamin A Fisher; Andrew Allard; Shirish Dubey; Kulveer Mankia; Arthur G Pratt; Lalit Pallan

doi:10.1016/j.clinme.2025.100496

Immune checkpoint inhibitor-induced inflammatory arthritis

Clin Med (Lond). 2025 Sep;25(5):100496. doi: 10.1016/j.clinme.2025.100496. Epub 2025 Aug 6.

Authors

Benjamin A Fisher¹, Andrew Allard², Shirish Dubey³, Kulveer Mankia⁴, Arthur G Pratt⁵, Lalit Pallan⁶

Affiliations

¹ Rheumatology Research Group, Department of Inflammation and Ageing, School of Infection, Inflammation and Immunology, University of Birmingham, Birmingham, UK; Department of Rheumatology and NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK. Electronic address: b.fisher@bham.ac.uk.
² Royal National Hospital for Rheumatic Diseases, Royal United Hospitals Bath NHSFT, Bath BA1 3NG, UK.
³ Dept of Rheumatology, Oxford University Hospitals NHS FT, Oxford OX3 7HE, UK; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford OX3 7LD, UK.
⁴ Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds UK; NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Chapel Allerton Hospital, Leeds, UK.
⁵ Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK; NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals and Newcastle University, Newcastle upon Tyne, UK.
⁶ Department of Oncology, University Hospitals NHS Foundation Trust, Birmingham, UK.

Abstract

Immune checkpoint inhibitors (ICI) used for the treatment of malignancy are associated with immune-related adverse events, which include inflammatory arthritis. ICI-induced inflammatory arthritis (ICI-IA) is a new clinical entity that may lead to functional impairment and may be persistent even after ICI cessation. We discuss the clinical features, investigation and differential diagnosis. Management needs to consider the safety of immunosuppression in the context of the underlying cancer, and current practice will be further informed by ongoing clinical trials.

Keywords: Adverse events; Anti-tnf; Arthritis; Cancer; Immune checkpoint inhibitors.

Publication types

Review

MeSH terms

Arthritis* / chemically induced
Arthritis* / diagnosis
Humans
Immune Checkpoint Inhibitors* / adverse effects
Immune Checkpoint Inhibitors* / therapeutic use
Neoplasms / drug therapy

Substances

Immune Checkpoint Inhibitors