Rheumatology Advances in Practice · Oct 8, 2026

Frailty characterization and patient-reported outcomes in patients with immune checkpoint inhibitor-related inflammatory arthritis and polymyalgia rheumatica

By von Eckstaedt HV, Weng KY, Jimenez DF et al.

OBJECTIVES: Immune checkpoint inhibitors (ICIs) have been associated with immune-related adverse events (irAEs), including inflammatory arthritis and polymyalgia rheumatica. We aimed to (i) characterize frailty status in patients who develop ICI-related inflammatory arthritis (ICI-IA) and immunotherapy-related polymyalgia rheumatica (ICI-PMR) and (ii) describe patient-reported outcomes (PROs) across key domains of the disease experience, stratified by frailty status. METHODS: Consecutive new referrals to our Rheumatology-irAE clinic between April 2024 and April 2025 for evaluation of ICI-IA or ICI-PMR were recruited to this cross-sectional study. Frailty and PROs were measured using validated surveys. PROMIS-29 domain scores were summarized descriptively for patients classified as robust/pre-frail versus frail. Given the small sample size, no inferential statistical testing was performed and no P-values are reported. RESULTS: A total of 14 patients (eight males and six females) were included, of whom 10 were characterized as robust or pre-frail and 4 as frail. The mean ages were similar between those robust/prefrail and frail patients. Two patients in each group had ICI-PMR. Two patients in the frail group were diagnosed with ICI-IA, compared with eight patients in the pre-frail group. Frail patients reported higher median scores in the fatigue and pain interference domains (median T-score fatigue 67.9 [IQR 65.5-70.6] versus 53.0 [IQR 48.6-57.1]; median T-score pain interference 66.7 [IQR 66.4-68.9] versus 58.2 [IQR 57.5-62.3]). Median social roles and activities and physical function scores were also lower in the frail group. CONCLUSION: In this small cross-sectional cohort, (i) frailty was present in approximately one-third of patients with ICI-related rheumatic irAEs and (ii) patients classified as frail reported higher fatigue and pain interference scores on PROMIS-29. These observations are descriptive and hypothesis-generating, and are intended to inform the design of larger prospective studies of frailty assessment and geriatric-informed care in this population.

doi.org/10.1093/rap/rkag122 Open access PubMed 42923939 Biomarkers