P480 Effectiveness of anti-inflammatory therapy in immune checkpoint inhibitor-induced diarrhoea/colitis

Ibraheim, Hajir; Samaan, M; Powell, Nicholas

doi:10.1093/ecco-jcc/jjx180.607

Cited by 1 publication

(1 citation statement)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Biologic therapy for management of gastrointestinal irAEs is recommended in patients with failure of corticosteroids 26 . In our review, roughly half the patients with flare of pre‐existing IBD who received immune checkpoint inhibitors and were steroid‐refractory, requiring escalation to biologic therapy.…”

Section: Discussionmentioning

confidence: 99%

Systematic review with meta‐analysis: safety and tolerability of immune checkpoint inhibitors in patients with pre‐existing inflammatory bowel diseases

Meserve

Facciorusso

Holmer

et al. 2020

Aliment Pharmacol Ther

View full text Add to dashboard Cite

SummaryBackgroundImmune checkpoint inhibitors may variably impact patients with pre‐existing autoimmune diseases.AimsTo evaluate the risks and outcomes of adverse events in patients with pre‐existing inflammatory bowel diseases treated with immune checkpoint inhibitors.MethodsThrough a systematic literature review up until July 31, 2020, we identified 12 studies reporting the impact of immune checkpoint inhibitors in 193 patients with inflammatory bowel disease. Outcomes of interest were relapse of inflammatory bowel disease, need for corticosteroids and/or biologics to manage inflammatory bowel disease relapse, and discontinuation of immune checkpoint inhibitors. We calculated pooled rates (with 95% confidence intervals [CI]) using random effects meta‐analysis, and examined risk factors associated with adverse outcomes through qualitative synthesis of individual studies.ResultsOn meta‐analysis, 40% patients (95% CI, 26%‐55%) experienced relapse of inflammatory bowel disease with immune checkpoint inhibitors. Among patients who experienced relapse, 76% (95% CI, 65%‐85%) required corticosteroids, and 37% (95% CI, 22%‐53%) required biologic therapy. Overall, 35% patients (95% CI, 17%‐57%) with inflammatory bowel disease discontinued immune checkpoint inhibitors. Gastrointestinal perforation and abdominal surgery due to immune checkpoint inhibitor complications occurred in <5% patients. In a large study, inhibitors of cytotoxic T‐lymphocyte antigen‐4 (CTLA‐4) were associated with a higher risk of relapse than programmed cell death 1 (PD‐1) and programmed death ligand 1 (PD‐L1) inhibitors.ConclusionsApproximately 40% of patients with pre‐existing inflammatory bowel diseases experience relapse with immune checkpoint inhibitors, with most relapsing patients requiring corticosteroids and one‐third requiring biologics. CTLA‐4 inhibitors may be associated with higher risk of relapse.

show abstract

Section: Discussionmentioning

confidence: 99%