The clinical characteristics, mechanism and management of immune checkpoint inhibitor-related arthritis
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Updated: Jan 31, 2026

An Adoptive Transfer Model of Rheumatoid Arthritis in Mice
Published on: June 6, 2025
Jian Gao1,2, Jinlin Miao2, Zhinan Chen1,2
1National Center for International Research of Bio-targeting Theranostics, Guangxi Key Laboratory of Bio-targeting Theranostics, Collaborative Innovation Center for Targeting Tumor Diagnosis and Therapy, Guangxi Talent Highland of Bio-targeting Theranostics, Guangxi Medical University, Nanning, China.
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.
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