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EPIDEMIOLOGY IN 2020

Spectrum and impact of checkpoint inhibitor-induced irAEs

  • Year in Review
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From Nature Reviews Rheumatology

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Immune checkpoint inhibitors, which are used to treat many types of cancer, can cause syndromes similar to rheumatic diseases known as immune-related adverse events (irAEs). In 2020, several studies illustrated the clinical heterogeneity of rheumatic irAEs and highlighted their substantial effect on morbidity and mortality.

Key advances

  • Immune checkpoint inhibitor (ICI)-induced myositis has a high mortality rate, particularly when associated with myocarditis and myasthenia gravis, and can happen shortly after ICI initiation2.

  • Rheumatic immune-related adverse events (irAEs) of all kinds necessitate systemic immunosuppression, and for most patients in one multicentre study, tumour response did not worsen after treatment of these irAEs3.

  • Patients with inflammatory arthritis attributable to ICI therapy experience substantial emotional and functional effects, outcomes that could be improved with increased awareness, multidisciplinary care and increased social support4.

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Fig. 1: New insights into the occurrence and effects of ICI-induced irAEs.

References

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  2. Allenbach, Y. et al. Immune checkpoint inhibitor-induced myositis, the earliest and most lethal complication among rheumatic and musculoskeletal toxicities. Autoimmun. Rev. 19, 102586 (2020).

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Authors and Affiliations

  1. Johns Hopkins University School of Medicine, Division of Rheumatology, Baltimore, MD, USA

    Laura C. Cappelli & Clifton O. Bingham III

Authors
  1. Laura C. Cappelli
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  2. Clifton O. Bingham III
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Correspondence to Laura C. Cappelli.

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Competing interests

L.C.C. and C.O.B. declare that they have received research funding from Bristol-Myers Squibb, and that L.C.C. has acted as a consultant for AbbVie.

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Cappelli, L.C., Bingham, C.O. Spectrum and impact of checkpoint inhibitor-induced irAEs. Nat Rev Rheumatol 17, 69–70 (2021). https://doi.org/10.1038/s41584-020-00546-2

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