Immune-mediated adverse rheumatic reactions following administration of immune checkpoint inhibitors

Abstract

Immunotherapy with immune checkpoint inhibitors (ICIs) opens up new prospects in treatment of malignancies, although this novel therapy quite often results in development of immune-related adverse events (irAEs), which can limit their clinical use. IrAEs can affect almost any organ system, including the endocrine, respiratory, digestive, nervous, other organs and the skin. Most often irAEs are characterized by moderate degree of severity, but complications are fatal in 2% of patients.The nature of irAEs significantly differs from the adverse reactions associated with use of standard chemotherapeutic agents, which usually cause immunosuppression (due to neutropenia). Of particular interest to clinicians are rheumatic irAEs, which can occur at any time after treatment and tend to persist even after ICIs discontinuation. This review analyzes the prevalence, clinical characteristics, and approaches to treatment of rheumatic irAEs.