Disease exacerbation is common in inflammatory bowel disease patients treated with immune checkpoint inhibitors for malignancy

World J Clin Cases. 2022 Feb 26;10(6):1787-1794. doi: 10.12998/wjcc.v10.i6.1787.


Background: Colitis is a known potential toxicity of immune checkpoint inhibitors (ICIs). Studies evaluating the risk of disease exacerbation following ICI treatment in patients with pre-existing inflammatory bowel disease (IBD) are limited.

Aim: To assess the clinical characteristics of IBD patients treated with ICIs and determine prevalence of subsequent IBD exacerbations.

Methods: We conducted a retrospective cohort study of all patients in the Stanford Research Repository database with pre-existing IBD who were exposed to ICIs.

Results: The prevalence of IBD exacerbation following ICI was 36.8% amongst 19 patients meeting inclusion criteria. Patients with exacerbations had more gastrointestinal-related hospitalizations (4 of 7) than patients without exacerbations (0 of 12; P = 0.0090).

Conclusion: The prevalence of IBD exacerbations following ICI was higher than reported rates of ICI-induced colitis and diarrhea in the general population and was associated with hospitalization.

Keywords: Immune checkpoint inhibitors; Immunotherapy; Inflammatory bowel disease; Malignancy.