ABSTRACT

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.

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.

中文翻译：

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免疫检查点抑制剂诱导的炎症性关节炎：识别和管理。

摘要

介绍

免疫检查点抑制剂 (ICIs) 已被证明在肿瘤学领域具有开创性。然而，来自 ICI 的免疫系统过度激活引入了一种新的医学实体，称为免疫相关不良事件 (irAE)，它可以影响任何器官或组织。ICI 诱导的炎症性关节炎 (ICI-IIA) 是最常见的肌肉骨骼 irAE，可导致显着的发病率和抗癌治疗的局限性。

覆盖区域

在这篇综述中，作者关注 ICI-IIA。相关文章是通过 PubMed 搜索确定的，时间跨度为 2010 年至今。作者详细介绍了目前对其发病机制、诊断评估和管理策略的理解。

专家意见

ICI-IIA 是一种复杂的 irAE，我们才刚刚开始从机制和病理上理解。它通常比其他 irAE 在病程中出现更晚，并且由于各种原因未被充分认识。在某些患者中，ICI-IIA 可能成为一种慢性疾病，这将其与大多数在 ICI 停用后消退的 irAE 区分开来。多个重要问题仍需要进一步研究，包括哪些患者可能会发展为 ICI-IIA？什么是可能的诊断和预后标志物？抗关节炎疗法会干扰抗肿瘤反应吗？什么时候应该开始使用类固醇激素药物？在管理这种特定的 irAE 时，肿瘤学家、风湿病学家和患者之间的密切合作和共同决策至关重要。