Figure 3.

General management of rheumatic immune-related adverse events (irAEs) due to cancer immunotherapy. Consultation with oncologists is required to decide whether to continue or terminate immune checkpoint inhibitors. If patients are refractory to nonsteroidal anti-inflammatory drugs, systemic glucocorticoids should be considered. Based on the severity, conventional synthetic disease-modifying antirheumatic drugs (DMARDs) and biological DMARDs, such as anti-tumor necrosis factor (TNF) or interleukin (IL)-6 inhibitor, should be considered. Targeted synthetic DMARDs, such as Janus kinase (JAK) inhibitors, are normally avoided because of the risk of exacerbating malignancies.