Nishimura Yoshito, Estaris Jonathan, Koseki Mako, Elias Evelyn, Chesta Fnu, Takaoka Kensuke, Shao Theresa, Horita Nobuyuki, Fujiwara Yu
Department of Medicine, Mayo Clinic, Rochester, MN, USA.
Department of Medicine, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI, USA.
Immunotherapy. 2025 Apr;17(6):437-446. doi: 10.1080/1750743X.2025.2501519. Epub 2025 May 8.
Although immune checkpoint inhibitors (ICIs) are widely used for patients with cancer, evidence of the impact of ICIs on the incidence of arthralgia remains limited.
To evaluate the impact of ICIs on arthralgia incidences in patients with cancer.
We performed a systematic review to identify phase 3 randomized control trials (RCTs) evaluating ICIs in patients with cancer and reporting the incidence of arthralgia. We performed a meta-analysis to pool odds ratios (ORs) of any grade and grade 3-5 arthralgia.
Forty RCTs ( = 26,610) were included. The incidence of any-grade and grade 3-5 treatment-related arthralgia was 12.0% ( = 1,125/9,395) and 0.54% ( = 47/8,723). The addition of an ICI to systemic therapy, such as chemotherapy, significantly increased any-grade (OR 1.32, 95% CI: 1.13-1.54, = 0.001) and grade 3-5 arthralgia (OR 1.78, 95% CI: 1.08-2.94, = 0.02) with low heterogeneity among ICI subtype subgroups ( = 0%). ICI monotherapy was associated with higher incidences of arthralgia than non-taxane (OR 6.83, 95% CI: 3.05-15.30, < 0.001) but not than taxane chemotherapy (OR 0.74, 95% CI: 0.44-1.24, = 0.25).
These results could guide oncologists to assess arthralgia in patients receiving ICIs.
尽管免疫检查点抑制剂（ICIs）被广泛应用于癌症患者，但关于ICIs对关节痛发生率影响的证据仍然有限。
评估ICIs对癌症患者关节痛发生率的影响。
我们进行了一项系统评价，以确定评估ICIs用于癌症患者并报告关节痛发生率的3期随机对照试验（RCTs）。我们进行了荟萃分析，汇总任何级别和3-5级关节痛的优势比（ORs）。
纳入了40项RCTs（n = 26,610）。任何级别和3-5级治疗相关关节痛的发生率分别为12.0%（n = 1,125/9,395）和0.54%（n = 47/8,723）。在全身治疗（如化疗）中添加ICIs，显著增加了任何级别（OR 1.32，95%CI：1.13-1.54，P = 0.001）和3-5级关节痛（OR 1.78，95%CI：1.08-2.94，P = 0.02），ICIs亚型亚组间异质性低（I² = 0%）。ICI单药治疗与关节痛发生率高于非紫杉烷类药物相关（OR 6.83，95%CI：3.05-15.30，P < 0.001），但与紫杉烷类化疗相比无差异（OR 0.74，95%CI：0.44-1.24，P = 0.25）。
这些结果可为肿瘤学家评估接受ICIs治疗的患者的关节痛提供指导。
