Division of Rheumatic Diseases, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Curr Opin Rheumatol. 2023 May 1;35(3):141-148. doi: 10.1097/BOR.0000000000000935. Epub 2023 Mar 9.
Immune check point inhibitors (ICIs) are a unique class of cancer treatments that harness the body's innate antitumor response. Although these medications have transformed oncology care, they also lead to generalized immune activation that can result in toxicities across a spectrum of organ systems called immune-related adverse events. This article reviews the most common rheumatologic immune-related adverse events and their management.
Inflammatory arthritis, polymyalgia rheumatic, sicca symptoms, systemic sclerosis, myositis, and vasculitis have all been reported as ICI adverse events. Treatment includes nonsteroidal anti-inflammatory drugs, glucocorticoids, traditional DMARDs, and biologics.
Rheumatologists have an important role in the management of patients with rheumatologic immune-related adverse events. Working with our oncology colleagues, we can help manage rheumatologic immune-related adverse events while optimally preserving ICI's antitumor effects.
免疫检查点抑制剂 (ICI) 是一类独特的癌症治疗药物，利用机体固有的抗肿瘤反应。尽管这些药物改变了肿瘤学治疗模式，但它们也会导致全身性免疫激活，从而导致一系列称为免疫相关不良事件的器官系统毒性。本文综述了最常见的风湿免疫相关不良事件及其管理。
已报道的 ICI 不良事件包括炎性关节炎、风湿性多肌痛、干燥症状、系统性硬化症、肌炎和血管炎。治疗包括非甾体抗炎药、糖皮质激素、传统 DMARDs 和生物制剂。
风湿科医生在管理风湿免疫相关不良事件方面发挥着重要作用。与肿瘤学同事合作，我们可以在最佳保留 ICI 抗肿瘤作用的同时，帮助管理风湿免疫相关不良事件。
