IL12/23 Blockade for Refractory Immune-Mediated Colitis: 2-Center Experience

Area of Science:

• Gastroenterology
• Immunology
• Oncology

Background:

• Immune checkpoint inhibitor-mediated colitis (IMC) is a significant side effect of cancer immunotherapy.
• Standard treatments include steroids and biologics, but some patients develop refractory disease.

Purpose of the Study:

• To evaluate the efficacy of ustekinumab (UST) in patients with IMC refractory to prior treatments.
• To assess clinical remission and inflammatory marker changes with UST therapy.

Main Methods:

• Retrospective analysis of 19 patients with refractory IMC treated with UST.
• Assessment of clinical remission, diarrhea severity, and fecal calprotectin levels before and after UST treatment.

Main Results:

• 13 out of 19 patients (68.4%) achieved clinical remission with UST.
• Significant reduction in mean fecal calprotectin levels was observed (629 to 92.0 mcg/mg, P = 0.0004).
• Most patients had severe diarrhea (grade ≥3) and colitis with ulceration prior to UST.

Conclusions:

• Ustekinumab (UST) is a potential therapeutic option for refractory immune checkpoint inhibitor-mediated colitis (IMC).
• UST demonstrates efficacy in achieving clinical remission and reducing inflammation in this challenging patient population.