Is it safe to treat checkpoint inhibitor-induced arthritis with methotrexate or biologics?

How the safety of methotrexate or biologics compares to long term steroid use to treated checkpoint-inhibitor inflammatory arthritis has not been determined. With that said, steroids can have deleterious effects on the tumor response in addition to all the other known side effects. Therefore, for patients that do not respond to steroids or cannot wean steroids it is appropriate to use methotrexate, TNF-inhibitors, or IL-6R inhibitors all of which have reported efficacy in the literature.