Immune checkpoint inhibitors are revolutionized drugs for cancer immunotherapy in the
last years. The mechanism of action of CPIs including the limitation of the activation of T-cells,
and thus enhancing the self-immune response against tumour cells. Checkpoint-inhibitors(CPIs)
may dysregulate the immune system, resulting in some toxicities. These toxicities or side effects
are called immune-related adverse events (IRAEs) that can potentially affect any organ and tissue.
Rheumatic diseases due to checkpoint inhibitors are also reported in the literature. The spectrum of
rheumatic manifestations are quite wide; the most common are arthralgia/arthritis, myalgia/
myositis, polimyalgia rheumatica, lupus, rheumatoid arthritis, Sjögren’s syndrome. At the same
time, these drugs can also cause an exacerbation of known rheumatologic disease. Treatment approaches
for developing rheumatic findings due to checkpoint inhibitors should be multidisciplinary.
There should be a close relationship between oncologists who follow-up these patients and
rheumatologists. The rheumatic manifestations should be defined and treated early. In general, the
musculoskeletal side effects are transient and may regress after stopping CPIs. The most commonly
used medications are corticosteroids. Immunosuppressive drugs (hydroxychloroquine,
methotrexate, anti-TNF-alpha, anti-IL-6) should also be preferred when treatment is unresponsive
or as steroid-sparing agents.
The aim of this review was to evaluate the checkpoint inhibitors-related rheumatologic findings and
therapeutic strategies in light of recent literature data.