Jason Laday , 2025-10-28 15:47:00
October 28, 2025
2 min read
Key takeaways:
- Glucocorticoids for immune checkpoint inhibitor-associated inflammatory arthritis, at doses prescribed by rheumatologists, had no impact on progression-free survival.
- The results suggest such doses may not substantially impact cancer outcomes.
CHICAGO — The use of glucocorticoids, at doses prescribed by rheumatologists, for inflammatory arthritis resulting from checkpoint inhibitors may not substantially impact cancer outcomes, according to data presented at ACR Convergence 2025.
“Glucocorticoids are a cornerstone of treatment for many cases of immune checkpoint inhibitor inflammatory arthritis (ICI-IA),” Deanna Jannat-Khah, MPH, DrPH, of the Hospital for Special Surgery, in New York, told Healio in an interview. “However, there is no standardized dose, taper regimen or duration for glucocorticoid treatment.
“Oncology and rheumatology guidelines provide mixed advice on the treatment of ICI-IA, including the recommended dosages of glucocorticoids for treatment,” she added. “Mixed results have been reported regarding the effect of oral glucocorticoids on cancer progression-free survival among ICI-treated patients.”
To examine the use of oral glucocorticoids and their impact on progression-free survival in ICI-IA, Jannat-Khah and colleagues analyzed data from the RADIOS (Rheumatology Adverse Events Due to Immunotherapy Observational Study) registry, a large, prospective, multicentered, national rheumatologic immune-related adverse event cohort.
The analysis included 206 patients with a mean age of 65 years who had been enrolled since February 2023, treated with ICI therapy for cancer, subsequently developed ICI-IA, and were then treated with glucocorticoids. The researchers defined ICI-IA as inflammatory arthritis, arthralgia or polymyalgia rheumatica. Most of the participants had either melanoma (32.5%), renal cell cancer (18.4%) or non-small cell lung cancer (11.7%), and were in stage 3 (26.7%) or 4 (58.3%).
Those with preexisting autoimmune diseases, or glucocorticoid use for another immune-related adverse event, were excluded. The researchers collected data on patients’ demographics, cancer diagnosis, cancer treatment, glucocorticoid use and disease-modifying anti-rheumatic drug use.
Median time from ICI-IA diagnosis to initial glucocorticoid dose was 24.5 days (IQR 3, 63).
According to the researchers, cancer progression occurred in 22.3% of patients, with the median time from glucocorticoid initiation to progression being 82.5 days (IQR -70, 283). In addition, they found the first-month median glucocorticoid dose was not associated with progression-free survival in a landmark Kaplan Meier curve (P = .99). Meanwhile, there were no differences between quartiles of glucocorticoid dose and progression-free survival in a Kaplan Meier curve (P = .31), and none of the adjusted Cox models were significant for glucocorticoid dose and progression-free survival, the researchers wrote.
“We demonstrated no relationship between glucocorticoid dose and progression-free survival in this very large, prospective, multicenter, national cohort of patients with ICI-IA,” Jannat-Khah said. “Of note, the glucocorticoid doses captured in this study were below 50 mg, with an average dose being 15 mg, which are lower than what is often prescribed by other specialties like oncology.
“Doses used by rheumatologists to treat ICI-IA are not associated with worse progression-free survival in cancer patients,” she added. “We investigated doses above and below the median, as well as by quartiles, and found no association with worse progression free survival. In our study, the median prednisone dose was 15 mg during the first month of ICI-IA treatment.”
According to Jannat-Khah, previous studies indicated that timing, in particular earlier use of glucocorticoids, might contribute to worse outcomes.
“Some patients present with ICI-IA a few months after starting ICI treatment,” she said. “We found that time from ICI initiation to ICI-IA diagnosis had a median of 216 days. After accounting for time, we found that glucocorticoid use was not associated with worse progression free survival.”
For more information:
Deanna Jannat-Khah, MPH, DrPH, can be reached at rennichr@hss.edu.
Sources/Disclosures
Source:
Jannat-Khah D. Abstract 1730. Presented at: ACR Convergence 2025; Oct. 24-29, 2024; Chicago.
Disclosures:
Jannat-Khah reports owning stock options or bond holdings in a for-profit corporation or self-directed pension plan with AstraZeneca and CytoDyn.
