AI Article Synopsis
- The rising elderly population is leading to an increase in malignancies among rheumatoid arthritis (RA) patients, complicating their treatment due to interactions with therapies like immune checkpoint inhibitors (ICIs).
- ICIs can trigger numerous immune-related adverse events (irAEs), including conditions that mimic autoimmune diseases, such as arthritis, myositis, and vasculitis, differentiating them from traditional rheumatic diseases.
- Effective management of these rheumatic irAEs requires personalized treatment plans and close collaboration between rheumatologists and oncologists to avoid serious health complications.
Article Abstract
With the aging of the population, malignancies are becoming common complications in patients with rheumatoid arthritis (RA), particularly in elderly patients. Such malignancies often interfere with RA treatment. Among several therapeutic agents, immune checkpoint inhibitors (ICIs) which antagonize immunological brakes on T lymphocytes have emerged as a promising treatment option for a variety of malignancies. In parallel, evidence has accumulated that ICIs are associated with numerous immune-related adverse events (irAEs), such as hypophysitis, myocarditis, pneumonitis, and colitis. Moreover, ICIs not only exacerbate pre-existing autoimmune diseases, but also cause de novo rheumatic disease-like symptoms, such as arthritis, myositis, and vasculitis, which are currently termed rheumatic irAEs. Rheumatic irAEs differ from classical rheumatic diseases in multiple aspects, and treatment should be individualized based on the severity. Close collaboration with oncologists is critical for preventing irreversible organ damage. This review summarizes the current evidence regarding the mechanisms and management of rheumatic irAEs with focus on arthritis, myositis, and vasculitis. Based on these findings, potential therapeutic strategies against rheumatic irAEs are discussed.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10051463 | PMC |
| http://dx.doi.org/10.3390/ijms24065643 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Comparative study of management strategies for immune checkpoint inhibitor-induced inflammatory arthritis: rheumatologists versus oncologists.
Intern Med J
January 2025
Department of Rheumatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
Background: Immune checkpoint inhibitors (ICIs) have significantly improved cancer treatment outcomes but are associated with immune-related adverse events (irAEs), such as inflammatory arthritis (ir-IA). Management of ir-IA is evolving, with corticosteroids as the primary treatment, though some cases require steroid-sparing agents.
Aims: This study aimed to compare initial mean prednisolone doses and disease persistence over 12 months in patients with rheumatoid arthritis (RA)-like ir-IA managed by rheumatologists or oncologists.
Severe Polymyalgia Rheumatica-Like Syndrome Induced by Immune Checkpoint Inhibitor: A Case Report and Literature Review.
Cureus
November 2024
Division of Medical Oncology, Department of Medicine, Showa University School of Medicine, Tokyo, JPN.
Immune checkpoint inhibitors (ICIs) have dramatically improved the prognosis of patients with cancers. However, ICIs can provoke systemic toxicities, which are known as immune-related adverse events (irAEs). Polymyalgia rheumatica (PMR)-like syndrome induced by ICI is one of the most common rheumatic irAEs.
View Article and Find Full Text PDFNK cells restrain cytotoxic CD8 T cells in the submandibular gland via PD-1-PD-L1.
Sci Immunol
December 2024
Department of Molecular Microbiology and Immunology, Division of Biology and Medicine, Brown University, Providence, RI 02912, USA.
The increasing use of anti-programmed cell death 1 (PD-1) immune checkpoint blockade has led to the emergence of immune-related adverse events (irAEs), including dysfunction of the submandibular gland (SMG). In this study, we investigated the immunoregulatory mechanism contributing to the susceptibility of the SMG to irAEs. We found that the SMGs of PD-1-deficient mice and anti-programmed cell death ligand 1 (PD-L1)-treated mice harbor an expanded population of CD8 T cells.
View Article and Find Full Text PDFThe knowledge and skills required for the onco-rheumatologist: Study of four-year consultation records of a high-volume cancer centre.
Mod Rheumatol
December 2024
Department of General Medicine, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.
Objectives: Onco-rheumatology, the intersection of oncology and rheumatology, is an emerging field requiring further definition. This study aimed to identify the knowledge and skills essential for rheumatologists in clinical oncology.
Methods: We retrospectively reviewed consultations with the onco-rheumatology department of a high-volume tertiary cancer centre in Japan from January 2020 to December 2023.
Impact of Age on Rheumatic Immune-related Adverse Events: Experience from the Canadian Research Group of Rheumatology in Immuno-Oncology (CanRIO).
J Rheumatol
December 2024
Shahin Jamal , University of British Columbia, Medicine, Rheumatology, Vancouver, Canada.
Objective: Immune checkpoint inhibitors (ICI) have revolutionized cancer outcomes but are limited by immunerelated adverse events (irAE), including rheumatic irAEs (Rh-irAE). Aging is associated with increased inflammation, referred to as "inflamm-aging". In this study, we explore the impact of age on severity, frequency, and treatment of Rh-irAEs.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!