{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T22:24:38Z","timestamp":1779920678932,"version":"3.53.1"},"reference-count":95,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,3,10]],"date-time":"2023-03-10T00:00:00Z","timestamp":1678406400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>In cancer, immune checkpoint inhibitors (ICIs) improve patient survival but may lead to severe immune-related adverse events (irAEs). Rheumatic irAEs are a distinct entity that are much more common in a real-life than in clinical trial reports due to their unspecific symptoms and them being a rare cause of hospitalization. This review focuses on an interdisciplinary approach to the management of rheumatic irAEs, including cooperation between oncologists, rheumatologists, and immunologists. We discuss the immunological background of rheumatic irAEs, as well as their unique clinical characteristics, differentiation from other irAEs, and treatment strategies. Importantly, steroids are not the basis of therapy, and nonsteroidal anti-inflammatory drugs should be administered in the front line with other antirheumatic agents. We also address whether patients with pre-existing rheumatic autoimmune diseases can receive ICIs and how antirheumatic agents can interfere with ICIs. Interestingly, there is a preclinical rationale for combining ICIs with immunosuppressants, particularly tumor necrosis factor \u03b1 and interleukin 6 inhibitors. Regardless of the data, the mainstay in managing irAEs is interdisciplinary cooperation between oncologists and other medical specialties.<\/jats:p>","DOI":"10.3390\/ijerph20064926","type":"journal-article","created":{"date-parts":[[2023,3,13]],"date-time":"2023-03-13T04:04:00Z","timestamp":1678680240000},"page":"4926","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Immune Checkpoint Inhibitor Related Rheumatological Complications: Cooperation between Rheumatologists and Oncologists"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6535-4841","authenticated-orcid":false,"given":"Renata","family":"Pacholczak-Madej","sequence":"first","affiliation":[{"name":"Department of Clinical Oncology, The Maria Sk\u0142odowska-Curie National Research Institute of Oncology, Krak\u00f3w Branch, 31-115 Krak\u00f3w, Poland"},{"name":"Department of Anatomy, Jagiellonian University Medical College, 33-332 Krak\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1013-2253","authenticated-orcid":false,"given":"Joanna","family":"Kosa\u0142ka-W\u0119giel","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, Jagiellonian University Medical Krak\u00f3w, 30-688 Krakow, Poland"},{"name":"Division of Rheumatology and Immunology Clinical, University Hospital, 30-688 Krak\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Kuszmiersz","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, Jagiellonian University Medical Krak\u00f3w, 30-688 Krakow, Poland"},{"name":"Division of Rheumatology and Immunology Clinical, University Hospital, 30-688 Krak\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerzy W.","family":"Mitu\u015b","sequence":"additional","affiliation":[{"name":"Department of Anatomy, Jagiellonian University Medical College, 33-332 Krak\u00f3w, Poland"},{"name":"Department of Surgical Oncology, National Research Institute of Oncology, Krak\u00f3w Branch, 31-115 Krak\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2647-9625","authenticated-orcid":false,"given":"Miros\u0142awa","family":"P\u00fcsk\u00fcll\u00fco\u011flu","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, The Maria Sk\u0142odowska-Curie National Research Institute of Oncology, Krak\u00f3w Branch, 31-115 Krak\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6727-8926","authenticated-orcid":false,"given":"Aleksandra","family":"Grela-Wojewoda","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, The Maria Sk\u0142odowska-Curie National Research Institute of Oncology, Krak\u00f3w Branch, 31-115 Krak\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariusz","family":"Korkosz","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, Jagiellonian University Medical Krak\u00f3w, 30-688 Krakow, Poland"},{"name":"Division of Rheumatology and Immunology Clinical, University Hospital, 30-688 Krak\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9634-0963","authenticated-orcid":false,"given":"Stanis\u0142awa","family":"Bazan-Socha","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Jagiellonian University Medical College, 30-688 Krak\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2006","DOI":"10.1056\/NEJMoa1414428","article-title":"Nivolumab and Ipilimumab versus Ipilimumab in Untreated Melanoma","volume":"372","author":"Postow","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1751","DOI":"10.1002\/acr.23177","article-title":"Rheumatic and Musculoskeletal Immune-Related Adverse Events Due to Immune Checkpoint Inhibitors: A Systematic Review of the Literature","volume":"69","author":"Cappelli","year":"2017","journal-title":"Arthritis Care Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1056\/NEJMoa1504030","article-title":"Combined Nivolumab and Ipilimumab or Monotherapy in Previously Untreated Melanoma","volume":"373","author":"Larkin","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1038\/s41584-018-0074-9","article-title":"Rheumatic Immune-Related Adverse Events from Cancer Immunotherapy","volume":"14","author":"Calabrese","year":"2018","journal-title":"Nat. Rev. Rheumatol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.ejca.2021.03.010","article-title":"Late-Onset and Long-Lasting Immune-Related Adverse Events from Immune Checkpoint-Inhibitors: An Overlooked Aspect in Immunotherapy","volume":"149","author":"Ghisoni","year":"2021","journal-title":"Eur. J. Cancer"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1687","DOI":"10.1007\/s10067-020-05420-w","article-title":"Treatment of Rheumatic Immune-Related Adverse Events Due to Cancer Immunotherapy with Immune Checkpoint Inhibitors\u2014Is It Time for a Paradigm Shift?","volume":"40","author":"Chatzidionysiou","year":"2021","journal-title":"Clin. Rheumatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e000412","DOI":"10.1136\/rmdopen-2016-000412","article-title":"Rheumatic Immune-Related Adverse Events of Checkpoint Therapy for Cancer: Case Series of a New Nosological Entity","volume":"3","author":"Calabrese","year":"2017","journal-title":"RMD Open"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1111\/ajco.13346","article-title":"Rheumatic Immune-Related Adverse Events Induced by Immune Checkpoint Inhibitors","volume":"17","author":"Zhong","year":"2021","journal-title":"Asia Pac. J. Clin. Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1016\/j.annonc.2022.10.001","article-title":"Management of Toxicities from Immunotherapy: ESMO Clinical Practice Guideline for Diagnosis, Treatment and Follow-up","volume":"33","author":"Haanen","year":"2022","journal-title":"Ann. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1136\/annrheumdis-2020-217139","article-title":"EULAR Points to Consider for the Diagnosis and Management of Rheumatic Immune-Related Adverse Events Due to Cancer Immunotherapy with Checkpoint Inhibitors","volume":"80","author":"Kostine","year":"2021","journal-title":"Ann. Rheum. Dis."},{"key":"ref_11","unstructured":"Abbas, A.K., Lichtman, A.H., and Pillai, S. (2021). Cellular and Molecular Immunology, Elsevier. [10th ed.]."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1038\/nri1349","article-title":"Co-Inhibitory Molecules of the B7-CD28 Family in the Control of T-Cell Immunity","volume":"4","author":"Chen","year":"2004","journal-title":"Nat. Rev. Immunol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1111\/j.1365-2567.2009.03059.x","article-title":"Genetic and Epigenetic Networks Controlling T Helper 1 Cell Differentiation","volume":"127","author":"Placek","year":"2009","journal-title":"Immunology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1146\/annurev.immunol.22.012703.104702","article-title":"Central Memory and Effector Memory T Cell Subsets: Function, Generation, and Maintenance","volume":"22","author":"Sallusto","year":"2004","journal-title":"Annu. Rev. Immunol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1038\/ni.2018","article-title":"Normal T Cell Homeostasis: The Conversion of Naive Cells into Memory-Phenotype Cells","volume":"12","author":"Sprent","year":"2011","journal-title":"Nat.Immunol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1056\/NEJMe058166","article-title":"Immunosuppression--the Promise of Specificity","volume":"353","author":"Ingelfinger","year":"2005","journal-title":"N. Engl. J. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1038\/s41423-019-0291-4","article-title":"Tissue-Resident Memory T Cells and Their Biological Characteristics in the Recurrence of Inflammatory Skin Disorders","volume":"17","author":"Chen","year":"2020","journal-title":"Cell. Mol. Immunol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1038\/ni.1899","article-title":"Effector T Cell Plasticity: Flexibility in the Face of Changing Circumstances","volume":"11","author":"Murphy","year":"2010","journal-title":"Nat. Immunol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1038\/ni944","article-title":"BTLA Is a Lymphocyte Inhibitory Receptor with Similarities to CTLA-4 and PD-1","volume":"4","author":"Watanabe","year":"2003","journal-title":"Nat. Immunol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12943-019-1091-2","article-title":"Novel Immune Checkpoint Targets: Moving beyond PD-1 and CTLA-4","volume":"18","author":"Qin","year":"2019","journal-title":"Mol. Cancer"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1038\/nrrheum.2016.131","article-title":"Immune Checkpoints and Rheumatic Diseases: What Can Cancer Immunotherapy Teach Us?","volume":"12","author":"Kuball","year":"2016","journal-title":"Nat. Rev. Rheumatol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.clim.2013.11.007","article-title":"Do Inhibitory Immune Receptors Play a Role in the Etiology of Autoimmune Disease?","volume":"150","author":"Koeleman","year":"2014","journal-title":"Clin. Immunol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1870","DOI":"10.1002\/art.27500","article-title":"The Programmed Death 1\/Programmed Death Ligand 1 Inhibitory Pathway Is up-Regulated in Rheumatoid Synovium and Regulates Peripheral T Cell Responses in Human and Murine Arthritis","volume":"62","author":"Raptopoulou","year":"2010","journal-title":"Arthritis Rheum."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1186\/s13075-015-0859-z","article-title":"Soluble PD-1 Aggravates Progression of Collagen-Induced Arthritis through Th1 and Th17 Pathways","volume":"17","author":"Liu","year":"2015","journal-title":"Arthritis Res."},{"key":"ref_25","unstructured":"(2022, December 30). Rheumatologic Complications of Checkpoint Inhibitor Immunotherapy-UpToDate. Available online: https:\/\/www.uptodate.com\/contents\/rheumatologic-complications-of-checkpoint-inhibitor-immunotherapy#H3841094854."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1002\/art.41949","article-title":"Predictors of Rheumatic Immune-Related Adverse Events and De Novo Inflammatory Arthritis after Immune Checkpoint Inhibitor Treatment for Cancer","volume":"74","author":"Wang","year":"2022","journal-title":"Arthritis Rheumatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1016\/S0140-6736(13)60954-X","article-title":"Immunopathogenic Mechanisms of Systemic Autoimmune Disease","volume":"382","year":"2013","journal-title":"Lancet"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1038\/ng.1076","article-title":"Five Amino Acids in Three HLA Proteins Explain Most of the Association between MHC and Seropositive Rheumatoid Arthritis","volume":"44","author":"Raychaudhuri","year":"2012","journal-title":"Nat. Genet."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1093\/rheumatology\/key358","article-title":"Association of HLA-DRB1 Shared Epitope Alleles and Immune Checkpoint Inhibitor-Induced Inflammatory Arthritis","volume":"58","author":"Cappelli","year":"2019","journal-title":"Rheumatology"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1126\/science.aao4572","article-title":"Patient HLA Class I Genotype Influences Cancer Response to Checkpoint Blockade Immunotherapy","volume":"359","author":"Chowell","year":"2018","journal-title":"Science"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1747","DOI":"10.1136\/annrheumdis-2017-211216","article-title":"Rheumatoid Arthritis and Polymyalgia Rheumatica Occurring after Immune Checkpoint Inhibitor Treatment","volume":"76","author":"Belkhir","year":"2017","journal-title":"Ann. Rheum. Dis."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1136\/annrheumdis-2017-212257","article-title":"Rheumatic Disorders Associated with Immune Checkpoint Inhibitors in Patients with Cancer-Clinical Aspects and Relationship with Tumour Response: A Single-Centre Prospective Cohort Study","volume":"77","author":"Kostine","year":"2018","journal-title":"Ann. Rheum. Dis."},{"key":"ref_33","unstructured":"(2022, July 21). Common Terminology Criteria for Adverse Events (CTCAE) v5.0, Available online: https:\/\/ctep.cancer.gov\/protocoldevelopment\/electronic_applications\/docs\/CTCAE_v5_Quick_Reference_5x7.pdf."},{"key":"ref_34","first-page":"1401","article-title":"Rheumatology Common Toxicity Criteria v.2.0 Personal Non-Commercial Use Only","volume":"34","author":"Woodworth","year":"2007","journal-title":"J. Rheumatol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1136\/annrheumdis-2019-216109","article-title":"Immune Checkpoint Inhibitor-Induced Inflammatory Arthritis Persists after Immunotherapy Cessation","volume":"79","author":"Braaten","year":"2020","journal-title":"Ann. Rheum. Dis."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1016\/j.semarthrit.2018.02.011","article-title":"Clinical Presentation of Immune Checkpoint Inhibitor-Induced Inflammatory Arthritis Differs by Immunotherapy Regimen","volume":"48","author":"Cappelli","year":"2018","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1002\/acr2.1026","article-title":"Sonographic Findings in Inflammatory Arthritis Secondary to Immune Checkpoint Inhibition: A Case Series","volume":"1","author":"Albayda","year":"2019","journal-title":"ACR Open Rheumatol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1634\/theoncologist.2016-0390","article-title":"Inflammatory Arthritis: A Newly Recognized Adverse Event of Immune Checkpoint Blockade","volume":"22","author":"Naidoo","year":"2017","journal-title":"Oncologist"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1136\/annrheumdis-2016-209595","article-title":"Inflammatory Arthritis and Sicca Syndrome Induced by Nivolumab and Ipilimumab","volume":"76","author":"Cappelli","year":"2017","journal-title":"Ann. Rheum. Dis."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1408","DOI":"10.1002\/ijc.32080","article-title":"Differential Effects of Corticosteroids and Anti-TNF on Tumor-Specific Immune Responses: Implications for the Management of IrAEs","volume":"145","author":"Draghi","year":"2019","journal-title":"Int. J. Cancer"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"E32","DOI":"10.1136\/annrheumdis-2020-217018","article-title":"Rheumatic Disorders Associated with Immune Checkpoint Inhibitors: What about Myositis? An Analysis of the WHO\u2019s Adverse Drug Reactions Database","volume":"81","author":"Maria","year":"2022","journal-title":"Ann. Rheum. Dis."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1097\/CJI.0000000000000196","article-title":"PD-1 Inhibitor-Associated Myopathies: Emerging Immune-Mediated Myopathies","volume":"41","author":"Liewluck","year":"2018","journal-title":"J. Immunother."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1001\/jamadermatol.2014.2233","article-title":"Drug-Associated Dermatomyositis Following Ipilimumab Therapy: A Novel Immune-Mediated Adverse Event Associated with Cytotoxic T-Lymphocyte Antigen 4 Blockade","volume":"151","author":"Ali","year":"2015","journal-title":"JAMA Derm."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1017\/S0317167100007939","article-title":"Autoimmune Inflammatory Myopathy after Treatment with Ipilimumab","volume":"36","author":"Hunter","year":"2009","journal-title":"Can. J. Neurol. Sci."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Albarr\u00e1n-Artahona, V., Laguna, J.C., Gorr\u00eda, T., Torres-Jim\u00e9nez, J., Pascal, M., and Mezquita, L. (2022). Immune-Related Uncommon Adverse Events in Patients with Cancer Treated with Immunotherapy. Diagnostics, 12.","DOI":"10.3390\/diagnostics12092091"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1158","DOI":"10.1016\/j.mayocp.2017.03.016","article-title":"Scleroderma Induced by Pembrolizumab: A Case Series","volume":"92","author":"Barbosa","year":"2017","journal-title":"Mayo Clin. Proc."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1080\/03009742.2019.1596309","article-title":"Nivolumab-Induced Anti-Aminoacyl-TRNA Synthetase Antibody-Positive Polymyositis Complicated by Interstitial Pneumonia in a Patient with Lung Adenocarcinoma","volume":"49","author":"Shikano","year":"2019","journal-title":"Scand. J. Rheumatol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e000906","DOI":"10.1136\/rmdopen-2019-000906","article-title":"Polymyalgia Rheumatica-like Syndrome from Checkpoint Inhibitor Therapy: Case Series and Systematic Review of the Literature","volume":"5","author":"Calabrese","year":"2019","journal-title":"RMD Open"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1002\/art.38282","article-title":"Drug-Associated Polymyalgia Rheumatica\/Giant Cell Arteritis Occurring in Two Patients after Treatment with Ipilimumab, an Antagonist of Ctla-4","volume":"66","author":"Goldstein","year":"2014","journal-title":"Arthritis Rheumatol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"387","DOI":"10.6004\/jnccn.2022.0020","article-title":"Management of Immunotherapy-Related Toxicities, Version 1.2022, NCCN Clinical Practice Guidelines in Oncology","volume":"20","author":"Thompson","year":"2022","journal-title":"J. Natl. Compr. Cancer Netw."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1259","DOI":"10.1634\/theoncologist.2018-0823","article-title":"Sicca Syndrome Associated with Immune Checkpoint Inhibitor Therapy","volume":"24","author":"Warner","year":"2019","journal-title":"Oncologist"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1111\/1756-185X.13076","article-title":"Immunotherapy-Induced Sarcoidosis in Patients with Melanoma Treated with PD-1 Checkpoint Inhibitors: Case Series and Immunophenotypic Analysis","volume":"20","author":"Lomax","year":"2017","journal-title":"Int. J. Rheum. Dis."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1053\/j.ajkd.2019.04.016","article-title":"Renal Vasculitis and Pauci-Immune Glomerulonephritis Associated With Immune Checkpoint Inhibitors","volume":"74","author":"Gallan","year":"2019","journal-title":"Am. J. Kidney Dis."},{"key":"ref_54","unstructured":"(2023, January 29). Clinical Manifestations and Diagnosis of Vasculitic Neuropathies-UpToDate. Available online: https:\/\/www-1uptodate-1com-1v54045na046f.hanproxy.cm-uj.krakow.pl\/contents\/clinical-manifestations-and-diagnosis-of-vasculitic-neuropathies?search=rheumatic%20complications%20immunotherapy&topicRef=8226&source=see_link#H2000456337."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1111\/j.1529-8027.2010.00281.x","article-title":"Peripheral Nerve Society Guideline on the Classification, Diagnosis, Investigation, and Immunosuppressive Therapy of Non-Systemic Vasculitic Neuropathy: Executive Summary","volume":"15","author":"Collins","year":"2010","journal-title":"J. Peripher. Nerv. Syst."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1056\/NEJMc0904283","article-title":"Anti-CTLA4 Antibody-Induced Lupus Nephritis","volume":"361","author":"Fadel","year":"2009","journal-title":"N. Engl. J. Med."},{"key":"ref_57","unstructured":"(2023, January 29). Overview of the Treatment and Prognosis of Systemic Sclerosis (Scleroderma) in Adults-UpToDate. Available online: https:\/\/www-1uptodate-1com-1v54045na046f.hanproxy.cm-uj.krakow.pl\/contents\/overview-of-the-treatment-and-prognosis-of-systemic-sclerosis-scleroderma-in-adults?search=rheumatic%20complications%20immunotherapy&topicRef=7539&source=see_link#H13."},{"key":"ref_58","unstructured":"(2023, January 29). Treatment of Pulmonary Sarcoidosis: Initial Approach to Treatment-UpToDate. Available online: https:\/\/www-1uptodate-1com-1v54045na046f.hanproxy.cm-uj.krakow.pl\/contents\/treatment-of-pulmonary-sarcoidosis-initial-approach-to-treatment?search=sarcoidosis&topicRef=4353&source=related_link."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"762247","DOI":"10.3389\/fmed.2021.762247","article-title":"Rheumatic Manifestations and Diseases From Immune Checkpoint Inhibitors in Cancer Immunotherapy","volume":"8","author":"Shen","year":"2021","journal-title":"Front. Med."},{"key":"ref_60","unstructured":"(2023, January 29). Treatment of Raynaud Phenomenon: Initial Management-UpToDate. Available online: https:\/\/www-1uptodate-1com-1v54045na046f.hanproxy.cm-uj.krakow.pl\/contents\/treatment-of-raynaud-phenomenon-initial-management?search=rheumatic%20complications%20immunotherapy&topicRef=7542&source=see_link."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"S415","DOI":"10.1016\/j.pmrj.2017.08.403","article-title":"A Focused Review of Safety Considerations in Cancer","volume":"9","author":"Maltser","year":"2017","journal-title":"PM&R"},{"key":"ref_62","unstructured":"(2023, January 29). Kidney Disease in Systemic Sclerosis (Scleroderma), Including Scleroderma Renal Crisis-UpToDate. Available online: https:\/\/www-1uptodate-1com-1v54045na046f.hanproxy.cm-uj.krakow.pl\/contents\/kidney-disease-in-systemic-sclerosis-scleroderma-including-scleroderma-renal-crisis?sectionName=Surveillance&search=rheumatic%20complications%20immunotherapy&topicRef=7542&anchor=H14&source=see_link#H152417808."},{"key":"ref_63","unstructured":"(2023, January 29). Treatment and Prognosis of Nonsystemic Vasculitic Neuropathy-UpToDate. Available online: https:\/\/www-1uptodate-1com-1v54045na046f.hanproxy.cm-uj.krakow.pl\/contents\/treatment-and-prognosis-of-nonsystemic-vasculitic-neuropathy?search=rheumatic%20complications%20immunotherapy&topicRef=8236&source=see_link."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1521","DOI":"10.1002\/art.40137","article-title":"2017 American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis","volume":"69","author":"Buckley","year":"2017","journal-title":"Arthritis Rheumatol."},{"key":"ref_65","first-page":"327","article-title":"Real-World Safety and Efficacy Data of Immunotherapy in Patients with Cancer and Autoimmune Disease: The Experience of the Hellenic Cooperative Oncology Group","volume":"71","author":"Fountzilas","year":"2022","journal-title":"Cancer Immunol. Immunother."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"e327","DOI":"10.1634\/theoncologist.2018-0618","article-title":"Clinical Outcomes of Patients with Advanced Cancer and Pre-Existing Autoimmune Diseases Treated with Anti-Programmed Death-1 Immunotherapy: A Real-World Transverse Study","volume":"24","author":"Cortellini","year":"2019","journal-title":"Oncologist"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1002\/art.40397","article-title":"Brief Report: Cancer Immunotherapy in Patients With Preexisting Rheumatic Disease: The Mayo Clinic Experience","volume":"70","author":"Richter","year":"2018","journal-title":"Arthritis Rheumatol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"121","DOI":"10.7326\/M17-2073","article-title":"Use of Immune Checkpoint Inhibitors in the Treatment of Patients With Cancer and Preexisting Autoimmune Disease: A Systematic Review","volume":"168","author":"Shah","year":"2018","journal-title":"Ann. Intern. Med."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"2100","DOI":"10.1002\/art.41068","article-title":"Safety and Efficacy of Immune Checkpoint Inhibitors in Patients With Cancer and Preexisting Autoimmune Disease: A Nationwide, Multicenter Cohort Study","volume":"71","author":"Tison","year":"2019","journal-title":"Arthritis Rheumatol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1905","DOI":"10.1200\/JCO.2017.77.0305","article-title":"Safety of Programmed Death-1 Pathway Inhibitors Among Patients With Non-Small-Cell Lung Cancer and Preexisting Autoimmune Disorders","volume":"36","author":"Leonardi","year":"2018","journal-title":"J. Clin. Oncol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1001\/jamaoncol.2015.4368","article-title":"Ipilimumab Therapy in Patients With Advanced Melanoma and Preexisting Autoimmune Disorders","volume":"2","author":"Johnson","year":"2016","journal-title":"JAMA Oncol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"854967","DOI":"10.3389\/fphar.2022.854967","article-title":"PD-1\/PD-L1 Inhibitors in Patients With Preexisting Autoimmune Diseases","volume":"13","author":"Zhang","year":"2022","journal-title":"Front Pharm."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1016\/j.annonc.2020.03.285","article-title":"Autoimmune Diseases and Immune-Checkpoint Inhibitors for Cancer Therapy: Review of the Literature and Personalized Risk-Based Prevention Strategy","volume":"31","author":"Haanen","year":"2020","journal-title":"Ann. Oncol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/j.ejca.2021.08.031","article-title":"Interleukin-6 Blockade for Prophylaxis and Management of Immune-Related Adverse Events in Cancer Immunotherapy","volume":"157","author":"Dimitriou","year":"2021","journal-title":"Eur. J. Cancer"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s40425-018-0484-x","article-title":"Complete Response of Metastatic Melanoma in a Patient with Crohn\u2019s Disease Simultaneously Receiving Anti-A4\u03b27 and Anti-PD1 Antibodies","volume":"7","author":"Frohne","year":"2019","journal-title":"J. Immunother. Cancer"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1093\/annonc\/mdw443","article-title":"Anti-PD-1 Therapy in Patients with Advanced Melanoma and Preexisting Autoimmune Disorders or Major Toxicity with Ipilimumab","volume":"28","author":"Menzies","year":"2017","journal-title":"Ann. Oncol."},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Lusa, A., Alvarez, C., Saxena Beem, S., Schwartz, T.A., and Ishizawar, R. (2022). Immune-Related Adverse Events in Patients with Pre-Existing Autoimmune Rheumatologic Disease on Immune Checkpoint Inhibitor Therapy. BMC Rheumatol., 6.","DOI":"10.1186\/s41927-022-00297-5"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.ejca.2017.12.008","article-title":"Safety and Efficacy of Anti-Programmed Death 1 Antibodies in Patients with Cancer and Pre-Existing Autoimmune or Inflammatory Disease","volume":"91","author":"Danlos","year":"2018","journal-title":"Eur. J. Cancer"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1158\/1078-0432.CCR-15-1136","article-title":"Nivolumab in Resected and Unresectable Metastatic Melanoma: Characteristics of Immune-Related Adverse Events and Association with Outcomes","volume":"22","author":"Kim","year":"2016","journal-title":"Clin. Cancer Res."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"6095","DOI":"10.1038\/s41467-022-33719-6","article-title":"Phase I Trial of the TNF-\u03b1 Inhibitor Certolizumab plus Chemotherapy in Stage IV Lung Adenocarcinomas","volume":"13","author":"Paik","year":"2022","journal-title":"Nat. Commun."},{"key":"ref_81","unstructured":"(2022, December 01). Tocilizumab, Ipilimumab, and Nivolumab for the Treatment of Advanced Melanoma, Non-Small Cell Lung Cancer, or Urothelial Carcinoma, Available online: https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04940299?term=NCT04940299&draw=2&rank=1."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1158\/1078-0432.CCR-20-3449","article-title":"Combining Nivolumab and Ipilimumab with Infliximab or Certolizumab in Patients with Advanced Melanoma: First Results of a Phase Ib Clinical Trial","volume":"27","author":"Montfort","year":"2021","journal-title":"Clin. Cancer Res."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"2256","DOI":"10.1038\/s41467-017-02358-7","article-title":"TNF\u03b1 Blockade Overcomes Resistance to Anti-PD-1 in Experimental Melanoma","volume":"8","author":"Bertrand","year":"2017","journal-title":"Nat. Commun."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"236","DOI":"10.15698\/cst2019.07.193","article-title":"Impact of Prophylactic TNF Blockade in the Dual PD-1 and CTLA-4 Immunotherapy Efficacy and Toxicity","volume":"3","author":"Alvarez","year":"2019","journal-title":"Cell Stress"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1038\/s41586-019-1162-y","article-title":"Prophylactic TNF Blockade Uncouples Efficacy and Toxicity in Dual CTLA-4 and PD-1 Immunotherapy","volume":"569","author":"Minute","year":"2019","journal-title":"Nature"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"2279","DOI":"10.1158\/0008-5472.CAN-16-2446","article-title":"Soluble IL6R Expressed by Myeloid Cells Reduces Tumor-Specific Th1 Differentiation and Drives Tumor Progression","volume":"77","author":"Tsukamoto","year":"2017","journal-title":"Cancer Res."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"e31761","DOI":"10.1097\/MD.0000000000031761","article-title":"Changes of IL-6 And IFN-\u03b3 before and after the Adverse Events Related to Immune Checkpoint Inhibitors: A Retrospective Study","volume":"101","author":"Zhang","year":"2022","journal-title":"Medicine"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1158\/1078-0432.CCR-14-2291","article-title":"Interleukin-6 as a Therapeutic Target","volume":"21","author":"Rossi","year":"2015","journal-title":"Clin. Cancer Res."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"1705","DOI":"10.1038\/leu.2014.13","article-title":"Single-Cell Genetic Analysis Reveals the Composition of Initiating Clones and Phylogenetic Patterns of Branching and Parallel Evolution in Myeloma","volume":"28","author":"Melchor","year":"2014","journal-title":"Leukemia"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1016\/j.ccell.2022.04.004","article-title":"Interleukin-6 Blockade Abrogates Immunotherapy Toxicity and Promotes Tumor Immunity","volume":"40","author":"Hailemichael","year":"2022","journal-title":"Cancer Cell"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1001\/jamaoncol.2019.5570","article-title":"Association Between Immune-Related Adverse Events and Recurrence-Free Survival Among Patients With Stage III Melanoma Randomized to Receive Pembrolizumab or Placebo: A Secondary Analysis of a Randomized Clinical Trial","volume":"6","author":"Eggermont","year":"2020","journal-title":"JAMA Oncol."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"2730","DOI":"10.1200\/JCO.19.00318","article-title":"Analysis of the Association Between Adverse Events and Outcome in Patients Receiving a Programmed Death Protein 1 or Programmed Death Ligand 1 Antibody","volume":"37","author":"Fernandes","year":"2019","journal-title":"J. Clin. Oncol."},{"key":"ref_93","doi-asserted-by":"crossref","unstructured":"Pacholczak-Madej, R., Grela-Wojewoda, A., Puskulluoglu, M., Lompart, J., Las-Jankowska, M., Krawczak, K., Wrona, E., Zar\u0119ba, L., \u017bubrowska, J., and Walocha, J. (2022). Early Effects of Nivolumab and Ipilimumab Combined Immunotherapy in the Treatment of Metastatic Melanoma in Poland: A Multicenter Experience. Biomedicines, 10.","DOI":"10.3390\/biomedicines10102528"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1111\/1756-185X.13444","article-title":"Association of Good Oncological Response to Therapy with the Development of Rheumatic Immune-Related Adverse Events Following PD-1 Inhibitor Therapy","volume":"22","author":"Liew","year":"2019","journal-title":"Int. J. Rheum. Dis."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1007\/s00262-017-2069-9","article-title":"Characterization of Arthralgia Induced by PD-1 Antibody Treatment in Patients with Metastasized Cutaneous Malignancies","volume":"67","author":"Benesova","year":"2018","journal-title":"Cancer Immunol. Immunother."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/6\/4926\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:52:25Z","timestamp":1760122345000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/6\/4926"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,10]]},"references-count":95,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2023,3]]}},"alternative-id":["ijerph20064926"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20064926","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,10]]}}}