Disease Outcomes in Immune-Mediated Colitis: A Study Describing Initial Endoscopic and Histologic Presentations and...

Area of Science:

• Oncology
• Gastroenterology
• Immunology

Background:

• Immune checkpoint inhibitors (ICIs) are increasingly used, leading to a rise in immune-mediated colitis (IMC).
• Previous studies on IMC have been limited by small sample sizes.
• This study provides a comprehensive analysis of IMC's clinical, endoscopic, and histologic features and treatment outcomes.

Purpose of the Study:

• To characterize the clinical, endoscopic, and histologic features of immune-mediated colitis (IMC).
• To evaluate the efficacy of treatments for IMC.
• To provide a comprehensive account of IMC in a large patient cohort.

Main Methods:

• Retrospective analysis of 1,151 patients who received ICIs and developed IMC between 2010 and 2024.
• Data collection included demographics, stool biomarkers, endoscopic and histologic findings, symptoms, treatments, and outcomes.
• Outcomes assessed included clinical remission, hospitalization, and mortality.

Main Results:

• Diarrhea (98.3%) and abdominal pain (38.6%) were common symptoms.
• Approximately 46% of patients required immunosuppressive therapy, with 85% achieving symptom remission.
• Infliximab showed a shorter time to clinical response compared to vedolizumab, with both treatments demonstrating comparable overall efficacy.

Conclusions:

• This is the largest study to date on immune-mediated colitis (IMC), detailing its diverse manifestations and treatment responses.
• IMC shares features with other inflammatory colitides.
• Both infliximab and vedolizumab are effective for IMC remission, but infliximab offers a quicker response; larger studies are needed.