Flare incidences of pre-existing rheumatologic diseases in patients with solid tumors receiving immune checkpoint inhibitors: A systematic review and meta-analysis
Authors' conclusion
Incidences of rheumatologic disease flare from ICIs vary depending on the underlying rheumatologic condition.
Study context
- Population
- Patients with solid tumors and pre-existing rheumatologic diseases treated with immune checkpoint inhibitors (ICIs); PubMed and Embase through May 202431 studies · >700 patients
- Outcome
- Pooled incidence of grade 1-5 flare of pre-existing rheumatologic disease
Methodological detailsrandom-effects proportional meta-analysis, stratified by rheumatologic disease types and ICI subtypes
- Random-effects proportional meta-analysis
- Stratified by rheumatologic disease types and ICI subtypes
Pooled result
As reported in the abstract
Grade 1-5 flare, pooled incidence
Pooled incidence of grade 1-5 flare
33.8%
95% CI 25.8–42.2%
Median onset after ICI initiation (IQR 30.0-52.6)
38.5 days
Further pooled results
Grade 3-5 flare incidence
- Grade 3-5 flare incidence
- 4.2% (95% CI 0.6-9.6)
Flare incidence by rheumatologic disease (subgroups)
- RA
- 40.9%
- PsA
- 46.4%
- SSc
- 11.3%
- SLE
- 3.8%
Management of flares
- Received systemic corticosteroids (n = 134/161)
- 83%
- Clinical improvement among such cases (n = 30/37)
- 81%
- ICIs permanently discontinued in flare cases
- 17%
Original publication
Flare incidences of pre-existing rheumatologic diseases in patients with solid tumors receiving immune checkpoint inhibitors: A systematic review and meta-analysis. Semin Arthritis Rheum. Published 31 January 2026. doi:10.
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