How do you manage psoriatic arthritis in patients who are planning to start treatment with checkpoint inhibitors for underlying malignancy?

This is a very important question, and I think rheumatologists will encounter cases like this more frequently as immune checkpoint inhibitors (ICIs) are being increasingly used. Roughly, 50% of patients with co-existing autoimmune disorders and malignancies have flare-ups of their autoimmune disorder after the ICI therapy. Based on my experiences and pieces of literature, the flare-up is mostly developed within the three cycles of the ICIs, especially after the 1st cycle of the ICIs (Abdel-Wahab...

Agree with Dr. @Dr. First Last’s answer. Holding immunosuppressants at the start of immunotherapy when possible is advised to give the chance for the best tumor response then close follow-up as the incidence of flares is high.