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ICPI-induced Microscopic Colitis Could be a Unique Disease Entity
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Microscopic colitis brought on by using immune checkpoint inhibitors might actually be a unique, more aggressive disease entity, according to research published in Inflammatory Bowel Diseases.
In a video abstract, Yinghong Wang, MD, PhD, of the department of gastroenterology at the University of Texas MD Anderson Cancer Center, said patients with immune checkpoint inhibitor (ICPIs)-related microscopic colitis require more assertive management than other patients with microscopic colitis.
“Although this is still a small case series, we recognize that despite the similarities in histologic features between microscopic colitis with and without [ICPI] exposure, this group behaves very differently with aggressive disease course that requires more potent immunosuppression therapy and hospitalization,” she said.
Wang and colleagues conducted a retrospective chart review of 65 patients diagnosed with microscopic colitis from 2012 to 2018. They grouped patients into three cohorts: patients with cancer and ICPI exposure (n = 15); patients with cancer without ICPI exposure (n = 39); and patients without cancer (n = 11).
Researchers compared risk factors, colitis treatments, endoscopic features and clinical outcomes among the three groups.
Wang and colleagues found that patients with ICPI-induced microscopic colitis needed more treatments with oral and intravenous steroids and immunosuppressive agents (all P < .001), and they had a higher rate of hospitalization (P < .001).
When they analyzed risk factors, researchers found that patients with ICPI-induced microscopic colitis had an increased use of non-steroidal anti-inflammatory drugs, H2 blockers and proton pump inhibitors. However, the difference was not significant except for PPIs (P = .04).
Wang and colleagues wrote that timely diagnosis and treatment are needed for patients with ICPI-induced microscopic colitis.
“It is possible that this [ICPI]-related microscopic colitis is a different disease entity that should be managed more aggressively,” Wang said in the video. “Another study with a bigger sample size is warranted for better clarification of this disease condition.” – by Alex Young
Disclosures: The authors report no relevant financial disclosures.
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