Immune checkpoint inhibitor induced colitis: A nationwide population-based study

Area of Science:

• Oncology
• Immunology
• Gastroenterology

Background:

• Immune checkpoint inhibitors (ICIs) are crucial in cancer treatment.
• Immune-related adverse events, including colitis, are significant side effects of ICIs.
• Understanding the epidemiology and risk factors for ICI-induced colitis is essential for patient management.

Purpose of the Study:

• To conduct an epidemiological survey of patients developing immune checkpoint inhibitor (ICI)-induced colitis.
• To identify demographic and clinical risk factors associated with ICI-induced colitis.
• To assess the incidence and characteristics of ICI-induced colitis in a large patient cohort.

Main Methods:

• A retrospective cohort study utilizing the Explorys US-based population database.
• Inclusion of patients treated with ICIs over a five-year period.
• Statistical analysis including odds ratios and multivariable analysis to identify risk factors.

Main Results:

• 3.6% of patients developed ICI-induced colitis.
• Increased risk observed in women, Caucasians, individuals over 65, obese patients, and those with a history of alcohol abuse.
• Specific ICIs (Nivolumab, Ipilimumab, Pembrolizumab, Atezolizumab) were associated with increased odds of colitis, with Ipilimumab posing the highest risk.

Conclusions:

• This study provides the largest epidemiological description of ICI-induced colitis to date.
• Ipilimumab is associated with the highest risk of developing ICI-induced colitis.
• Discussion of colitis risk is crucial for patients before initiating ICI therapy, potentially influencing treatment selection.