REVIEW article
Front. Immunol.
Sec. Inflammation
The clinical characteristics, mechanism and management of immune checkpoint inhibitor-related arthritis
Provisionally accepted
- 1National Center for International Research of Biological Targeting Diagnosis and Therapy, Guangxi Medical University, Nanning, Guangxi Zhuang Region, China
- 2Xijing Hospital, Air Force Medical University, Xi’an, China
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Background: Immune-related adverse events, notably arthritis (irAE-arthritis), frequently occur in patients receiving immune checkpoint inhibitors. Arthritis severity varies from mild to severe, adversely impacting quality of life. Despite reports in clinical trials and real-world studies, the pathophysiology and optimal management of irAE-associated arthritis (irAE-arthritis) are still unclear. Methods: From the inception to September 25, 2025, a search was conducted on PubMed, EMBASE, and MEDLINE for case reports/series on irAE-arthritis. Findings: The most common rheumatic irAEs were arthritis. Various rheumatic syndromes have been reported, such as arthralgia, mono-/oligo-/polyarthritis, reactive and psoriatic arthritis, RS3PE, tenosynovitis. The onset of irAE-arthritis is attributed to T cell dysregulation, B cell activation with autoantibody production, cytokine - mediated inflammation, and impaired immune tolerance due to Treg dysfunction. NSAIDs, intra-articular/systemic corticosteroids, csDMARDs, and biologics play key roles in irAE-arthritis management, and JAK inhibitors may emerge as a significant therapeutic strategy in the future. Conclusion: Given the increasing use of immunotherapy in oncology and other fields, developing a comprehensive understanding of irAE-arthritis is crucial. This review aims to provide an in-depth overview of current knowledge on irAE-arthritis, including its epidemiology, clinical presentation, underlying mechanisms, and management approaches.
Keywords: Arthritis, immune checkpoint inhibitors, Immunotherapy, irAEs, tumor
Received: 14 Apr 2025; Accepted: 08 Dec 2025.
Copyright: © 2025 Gao, Miao, Zhu and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Ping Zhu
Zhinan Chen
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