Clinical Course and Impact of Immune Checkpoint Inhibitor Colitis Resembling Microscopic Colitis.
colitis
drug-related side effects and adverse reactions
immune checkpoint inhibitors
inflammatory bowel diseases
microscopic
Journal
Crohn's & colitis 360
ISSN: 2631-827X
Titre abrégé: Crohns Colitis 360
Pays: England
ID NLM: 101752188
Informations de publication
Date de publication:
Apr 2022
Apr 2022
Historique:
received:
15
11
2021
entrez:
13
2
2023
pubmed:
14
2
2023
medline:
14
2
2023
Statut:
epublish
Résumé
Microscopic colitis (MC) is suspected to result from increased immune activity in gut mucosa. Immune checkpoint inhibitors (ICIs) treat cancer by activating the immune system, and further investigation is needed regarding their role in the development of MC. A retrospective case series investigated cases of endoscopically and histologically confirmed MC developing after administration of ICIs. Clinical notes and medication administration records were reviewed for demographics, symptom duration, and treatment response. Nineteen cases of de novo MC were identified, with 95% of cases requiring steroid treatment, 53% presenting with hospitalization, and colitis-related mortality in 1 individual. Symptom onset occurred a median of 160 days after initiation of ICI therapy and 53 days after their most recent dose of therapy. Patients had a median of 125 days of symptoms, and ICI therapy was held in 70% of individuals due for treatment. MC can develop after ICI administration, and presents with severe symptoms, often requiring hospitalization and steroid treatment. In certain individuals this can require a prolonged treatment course of steroid therapy or immunomodulators. Individuals developing diarrhea after ICI therapy warrant thorough workup including endoscopy and rapid treatment initiation given the disease severity observed in this series.
Sections du résumé
Background
UNASSIGNED
Microscopic colitis (MC) is suspected to result from increased immune activity in gut mucosa. Immune checkpoint inhibitors (ICIs) treat cancer by activating the immune system, and further investigation is needed regarding their role in the development of MC.
Methods
UNASSIGNED
A retrospective case series investigated cases of endoscopically and histologically confirmed MC developing after administration of ICIs. Clinical notes and medication administration records were reviewed for demographics, symptom duration, and treatment response.
Results
UNASSIGNED
Nineteen cases of de novo MC were identified, with 95% of cases requiring steroid treatment, 53% presenting with hospitalization, and colitis-related mortality in 1 individual. Symptom onset occurred a median of 160 days after initiation of ICI therapy and 53 days after their most recent dose of therapy. Patients had a median of 125 days of symptoms, and ICI therapy was held in 70% of individuals due for treatment.
Conclusions
UNASSIGNED
MC can develop after ICI administration, and presents with severe symptoms, often requiring hospitalization and steroid treatment. In certain individuals this can require a prolonged treatment course of steroid therapy or immunomodulators. Individuals developing diarrhea after ICI therapy warrant thorough workup including endoscopy and rapid treatment initiation given the disease severity observed in this series.
Identifiants
pubmed: 36777041
doi: 10.1093/crocol/otac008
pii: otac008
pmc: PMC9802423
doi:
Types de publication
Journal Article
Langues
eng
Pagination
otac008Informations de copyright
© The Author(s) 2022. Published by Oxford University Press on behalf of Crohn's & Colitis Foundation.
Références
J Crohns Colitis. 2016 Apr;10(4):395-401
pubmed: 26783344
Mol Immunol. 2013 Oct;55(3-4):355-64
pubmed: 23566938
Clin Transl Gastroenterol. 2019 Sep;10(9):e00071
pubmed: 31478957
Gastrointest Endosc. 2019 Dec;90(6):881-892
pubmed: 31526811
Inflamm Bowel Dis. 2019 Jan 10;25(2):385-393
pubmed: 30169584
Am J Gastroenterol. 2020 Feb;115(2):202-210
pubmed: 31922959
Am J Gastroenterol. 2015 Feb;110(2):265-76; quiz 277
pubmed: 25623658
J Immunother Cancer. 2019 Nov 7;7(1):292
pubmed: 31699151
J Crohns Colitis. 2017 Oct 01;11(10):1238-1246
pubmed: 28967957