Pankti Reid, Namrata Singh, Tawnie Braaten, Laura C Cappelli
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The management of rheumatic immune related adverse events.
Immune checkpoint inhibitors (ICI) used for the treatment of cancer can cause immune related adverse events (irAEs) when immune activation affects non-tumor tissues. Rheumatologists care for patients with a variety of rheumatic irAEs; these included inflammatory arthritis (ICI-IA), polymyalgia rheumatica (ICI-PMR), and myositis (ICI-myositis) among others. Rheumatic irAEs are commonly impactful on patients' quality of life and function and sometimes can cause significant morbidity and mortality. This review will highlight the diagnosis and assessment of rheumatic irAEs. Then treatment for individual irAEs will be discussed in depth with considerations to supportive care, corticosteroid dosing and tapering, steroid sparing immunosuppression and monitoring. Finally, the safety of immunosuppression as it relates to tumor outcomes and considerations by oncologists when selecting ICI therapy will be reviewed.
期刊介绍：
Evidence-based updates of best clinical practice across the spectrum of musculoskeletal conditions.
Best Practice & Research: Clinical Rheumatology keeps the clinician or trainee informed of the latest developments and current recommended practice in the rapidly advancing fields of musculoskeletal conditions and science.
The series provides a continuous update of current clinical practice. It is a topical serial publication that covers the spectrum of musculoskeletal conditions in a 4-year cycle. Each topic-based issue contains around 200 pages of practical, evidence-based review articles, which integrate the results from the latest original research with current clinical practice and thinking to provide a continuous update.
Each issue follows a problem-orientated approach that focuses on the key questions to be addressed, clearly defining what is known and not known. The review articles seek to address the clinical issues of diagnosis, treatment and patient management. Management is described in practical terms so that it can be applied to the individual patient. The serial is aimed at the physician in both practice and training.
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