Chronic Use of Proton Pump Inhibitors Is Associated With an Increased Risk of Immune Checkpoint Inhibitor Colitis in Renal Cell Carcinoma.
Colitis
Immunotherapy
Kidney Cancer
Proton Pump Inhibitor
Journal
Clinical genitourinary cancer
ISSN: 1938-0682
Titre abrégé: Clin Genitourin Cancer
Pays: United States
ID NLM: 101260955
Informations de publication
Date de publication:
06 2022
06 2022
Historique:
received:
17
05
2021
revised:
20
12
2021
accepted:
25
01
2022
pubmed:
13
3
2022
medline:
31
5
2022
entrez:
12
3
2022
Statut:
ppublish
Résumé
Immune checkpoint inhibitors (ICIs) have become a standard of care in metastatic renal cell carcinoma (mRCC) but are associated with immune-related adverse events (irAEs) including colitis. Growing evidence suggests proton pump inhibitors (PPIs) increase the risk of inflammatory bowel disease (IBD). Given the pathophysiological overlap between IBD and ICI colitis, we sought to evaluate the relationship between PPI use and ICI colitis in mRCC patients. We performed a retrospective study of adult patients who received ICI therapy for mRCC between 2015 and 2018 at University of Texas Southwestern Medical Center affiliated hospitals. Clinical characteristics, oncological outcomes, ICI colitis details, and PPI use details were collected by manual chart review. The diagnosis of ICI colitis was made via biopsy when available, or by clinical criteria (symptoms and response to immunosuppressive therapy) when biopsy specimens were unavailable or inconclusive. Univariable and multivariable logistic regression analyses were conducted to assess the potential contribution of PPIs to ICI colitis. A total of 176 patients received ICI therapy for mRCC, of which 16 (9.1%) were diagnosed with ICI colitis. Patients with ICI colitis presented with elevated stool lactoferritin and calprotectin and a wide range of endoscopic and histologic findings. There were no significant differences between patients with and without ICI colitis in age, gender, medical comorbidities, RCC history, and overall survival. However, exposure to ipilimumab and PPI use were more frequently observed in patients with ICI colitis than those without. In univariable and multivariable logistic regression analyses, exposure to ipilimumab and chronic use of PPIs > 8 weeks were significantly associated with ICI colitis. In addition to ipilimumab use, chronic use of PPIs may be associated with ICI colitis in patients with mRCC.
Identifiants
pubmed: 35277350
pii: S1558-7673(22)00035-0
doi: 10.1016/j.clgc.2022.01.017
pmc: PMC9701615
mid: NIHMS1850387
pii:
doi:
Substances chimiques
Immune Checkpoint Inhibitors
0
Ipilimumab
0
Proton Pump Inhibitors
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
260-269Subventions
Organisme : NCI NIH HHS
ID : P50 CA196516
Pays : United States
Organisme : NIDDK NIH HHS
ID : T32 DK007745
Pays : United States
Informations de copyright
Copyright © 2022 Elsevier Inc. All rights reserved.
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