For ICI arthritis, how soon do you start DMARDs?

Great question!

This is complicated- is it one joint? Inject with steroids! Are there many joints? Is it gout-based, spondyloarthropathy, or more like seronegative RA or PMR-like?

Also, where are they in the cancer space? In surveillance but high risk, what type of cancer, etc, etc

I start this way: 2...

This is a loaded question: If you are a rheuamtologist the answer is always at the same time, the entire goal to get off steroids. Steroids are your best friend and worst enemy, meaning: the most reliable and quick, cheap way to decrease inflammation -- this is the bridge to by time until the drugs ...

Keeping in mind that oral steroids can decrease the effectiveness of immunotherapy, if need for chronic steroids, then there is a need for a DMARD! Remember to discuss with oncology and have the pharmacist confirm that there are no interactions with the current cancer regimen and DMARD of choice.