ACR Open Rheumatol

How do immune checkpoint inhibitors impact autoimmune disease risk?

March 28, 2025

Study details: This retrospective observational study evaluated the prevalence of new-onset autoimmune conditions in patients treated with immune checkpoint inhibitors (ICIs). The study included patients with neoplasms for which ICIs were approved, stratified into ICI users and non-users.

Results: Among 5,259,415 patients diagnosed with neoplasms, 2.03% (n=106,809) received ICIs. Compared with non-ICI users, ICI recipients were generally younger (mean age: 68.7 vs. 71.8 years) and predominantly male (54% vs. 41%). Both groups were primarily White (68% vs. 58%). Patients treated with ICIs exhibited a higher prevalence of rheumatoid arthritis (RA) (2.194% vs. 1.752%, odds ratio 1.258; P <.0001). Conversely, the odds of developing systemic lupus erythematosus and systemic sclerosis were lower in the ICI group. No significant differences were observed in the incidence of vasculitis, dermatomyositis, and psoriatic arthritis between the two groups.

Clinical impact: These findings highlight the need for heightened vigilance among clinicians prescribing ICIs, particularly regarding the increased risk of RA. Early identification and management of autoimmune conditions in these patients are crucial to mitigate potential complications and optimize patient outcomes.

Source:

Khandwala P, et al. (2025, January). ACR Open Rheumatol. Prevalence of Autoimmune Diseases in Patients Treated With Immune Checkpoint Inhibitors: An Epidemiological Study Using A Global Network of Health Care Organizations. https://pubmed.ncbi.nlm.nih.gov/39854167/