Abstract
The introduction of immune checkpoint inhibitor (ICI) therapy to treat cancer has changed the treatment paradigm for many solid tumors. These agents exploit suppressor and regulatory pathways to boost integrated immunity against tumors but are attended by a unique spectrum of immune-related adverse events (irAEs) related to their untoward autoinflammatory and off-target effects. The field of irAEs from checkpoint inhibitor therapy is growing at a rapid pace and there remain many unanswered questions. IrAEs have been described in nearly every organ system, including a variety of rheumatic manifestations (arthralgia, inflammatory arthritis, polymyalgia rheumatic, sicca syndrome, vasculitis, myositis, and others). Rheumatic irAEs are among the least understood and their true prevalence is unknown. Their natural history is also poorly defined. Whereas the more common irAEs often appear to be self-limited or resolve with effective immunosuppressive therapy, rheumatic irAEs may have a more persistent course, with some requiring treatment long after discontinuation of checkpoint inhibitor therapy. In this chapter, the current literature on rheumatic irAEs is summarized, including prevalence, clinical spectrum diagnosis, and treatment.
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