The Utility of Laboratory Investigations for the Assessment and Management of Rheumatic Immune Related Adverse Events

Alexandra Ladouceur; Aiarpi Ezdoglian; Jeffrey A Sparks; Marie Hudson; Shahin Jamal; Alison Clifford; Janet Roberts; Carrie Ye

doi:10.1016/j.rdc.2024.01.003

The Utility of Laboratory Investigations for the Assessment and Management of Rheumatic Immune Related Adverse Events

Rheum Dis Clin North Am. 2024 May;50(2):181-199. doi: 10.1016/j.rdc.2024.01.003. Epub 2024 Feb 22.

Authors

Alexandra Ladouceur¹, Aiarpi Ezdoglian², Jeffrey A Sparks³, Marie Hudson⁴, Shahin Jamal⁵, Alison Clifford⁶, Janet Roberts⁷, Carrie Ye⁸

Affiliations

¹ Division of Rheumatology, Department of Medicine, Jewish General Hospital and McGill University, 3755 Côte Ste-Catherine Road, Montreal, Quebec H3T 1E2, Canada.
² Department of Rheumatology and Clinical Immunology, Amsterdam University Medical Center, VU University Medical Center (VUmc), De Boelelaan 1118, Amsterdam 1081 HZ, the Netherlands.
³ Division of Rheumatology, Inflammation, and Immunity, Department of Medicine, Brigham and Women's Hospital, 60 Fenwood Road, Suite 6016U, Boston, MA 02115, USA.
⁴ Division of Rheumatology, Department of Medicine, Jewish General Hospital and McGill University, Lady Davis Institute for Medical Research, 3755 Côte Ste-Catherine Road, Montreal, Quebec H3T 1E2, Canada.
⁵ Arthritis Research Canada, Department of Medicine, University of British Columbia, Gordon & Leslie Diamond Health Care Centre, 2775 Laurel Street, Ste 8205B, Vancouver, British Columbia V5Z 1M9, Canada.
⁶ Faculty of Medicine & Dentistry, Department of Medicine, University of Alberta, 8-130 Clinical Sciences Building, 11350 83 Avenue NW, Edmonton, Alberta T6G 2G3, Canada.
⁷ Division of Rheumatology, Department of Medicine, Queen Elizabeth II Health Sciences Center and Dalhousie University, Nova Scotia rehabilitation and Arthritis Centre, Arthritis Research Canada; Lady Davis Institute for Medical Research, 1341 Summer Street, Halifax, Nova Scotia B3H 4K4, Canada.
⁸ Department of Medicine, University of Alberta, 8-130 Clinical Sciences Building, 11350 83 Avenue NW, Edmonton, Alberta T6G 2G3, Canada. Electronic address: cye@ualberta.ca.

PMID: 38670720
DOI: 10.1016/j.rdc.2024.01.003

Abstract

Immune checkpoint inhibitors (ICIs) have greatly improved survival of several cancers with historically very poor prognosis. ICIs act by stimulating the patient's own immune system to fight cancer. Simultaneously, this immune activation can lead to immune-related adverse events (irAEs), including rheumatic manifestations (Rh-irAEs). Rh-irAEs mimic primary rheumatic diseases including arthritis, polymyalgia rheumatica, myositis, vasculitis, sarcoidosis, and sicca. This article summarizes the latest evidence regarding the utility of laboratory investigations in Rh-irAEs.

Keywords: Antibodies; Arthritis; Autoimmune diseases; Immune checkpoint inhibitors; Inflammatory markers; Myositis; Rheumatic immune-related adverse events.

Publication types

Review

MeSH terms

Humans
Immune Checkpoint Inhibitors* / adverse effects
Neoplasms / drug therapy
Neoplasms / immunology
Rheumatic Diseases* / drug therapy
Rheumatic Diseases* / immunology

Substances

Immune Checkpoint Inhibitors