PMID- 36123319
OWN - NLM
STAT- MEDLINE
DCOM- 20221013
LR  - 20230509
IS  - 1365-2036 (Electronic)
IS  - 0269-2813 (Linking)
VI  - 56
IP  - 9
DP  - 2022 Nov
TI  - Safety and efficacy of infliximab and corticosteroid therapy in checkpoint 
      inhibitor-induced colitis.
PG  - 1370-1382
LID - 10.1111/apt.17201 [doi]
AB  - BACKGROUND: Cancer patients treated with immune check point inhibitors are at 
      risk of developing severe colitis. However, the efficacy and safety of treatment 
      of severe colitis is poorly understood. AIMS: To explore the safety and efficacy 
      of infliximab and corticosteroids in severe immune-mediated enterocolitis (IMC) 
      METHOD: We performed a nationwide retrospective cohort study on 140 cancer 
      patients treated with infliximab due to IMC in Denmark from 2011 to 2021. 
      RESULTS: The rate of complete remission with infliximab was 52% after one dose, 
      increasing to 73% after two or more doses. Thirteen patients (10%) required 
      additional treatment with vedolizumab. Patients were heavily exposed to 
      corticosteroids and received a median accumulated dose of 3978 mg (interquartile 
      range [IQR] 2552-6414). Age- and cancer-adjusted Cox regression analysis found 
      that a high dose of prednisolone at start of tapering >/=75 mg/day was associated 
      with increased mortality (HR 1.67, 1.04-2.69, p = 0.035). Patients responding to 
      infliximab experienced an improvement of symptoms after 3 days (IQR 2-4) and 
      complete remission after 31 days (IQR 14-61). Twenty-four percent required 
      hospitalisation for infection during treatment for IMC, lasting 7 days (median). 
      Secondary gastrointestinal infections occurred in 16%, with Clostridioides 
      difficile being most common (64%). Further, 10% had a thromboembolic event during 
      the first 90 days after infliximab treatment. CONCLUSIONS: Infliximab led to 
      complete resolution of symptoms in 73% of patients with IMC. High prednisolone 
      dose at tapering was associated with increased mortality rate and a high 
      incidence of infections and hospitalisations in patients with severe IMC. We 
      suggest optimised infliximab treatment before escalation of steroid doses.
CI  - (c) 2022 John Wiley & Sons Ltd.
FAU - Dahl, Emilie Kristine
AU  - Dahl EK
AUID- ORCID: 0000-0002-1383-5619
AD  - Department of Gastroenterology, Copenhagen University Hospital, Herlev, Denmark.
FAU - Abed, Osama Karim
AU  - Abed OK
AD  - Department of Gastroenterology, Odense University Hospital, Odense, Denmark.
AD  - Research Unit of Medical Gastroenterology, Department of Clinical Research, 
      University of Southern Denmark, Odense, Denmark.
FAU - Kjeldsen, Jens
AU  - Kjeldsen J
AD  - Department of Gastroenterology, Odense University Hospital, Odense, Denmark.
AD  - Research Unit of Medical Gastroenterology, Department of Clinical Research, 
      University of Southern Denmark, Odense, Denmark.
FAU - Donia, Marco
AU  - Donia M
AD  - Department of Oncology, Copenhagen University Hospital, Herlev, Denmark.
FAU - Svane, Inge Marie
AU  - Svane IM
AD  - Department of Oncology, Copenhagen University Hospital, Herlev, Denmark.
FAU - Dige, Anders
AU  - Dige A
AD  - Department of Hepatology and Gastroenterology, Aarhus University Hospital, 
      Aarhus, Denmark.
FAU - Agnholt, Jorgen Steen
AU  - Agnholt JS
AD  - Department of Hepatology and Gastroenterology, Aarhus University Hospital, 
      Aarhus, Denmark.
FAU - Bjerrum, Jacob Tveiten
AU  - Bjerrum JT
AD  - Department of Gastroenterology, Copenhagen University Hospital, Herlev, Denmark.
FAU - Seidelin, Jakob Benedict
AU  - Seidelin JB
AD  - Department of Gastroenterology, Copenhagen University Hospital, Herlev, Denmark.
LA  - eng
PT  - Journal Article
DEP - 20220919
PL  - England
TA  - Aliment Pharmacol Ther
JT  - Alimentary pharmacology & therapeutics
JID - 8707234
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Gastrointestinal Agents)
RN  - 9PHQ9Y1OLM (Prednisolone)
RN  - B72HH48FLU (Infliximab)
SB  - IM
CIN - Aliment Pharmacol Ther. 2023 Jan;57(1):152-153. PMID: 36468203
CIN - Aliment Pharmacol Ther. 2023 Jan;57(1):150-151. PMID: 36468245
CIN - Aliment Pharmacol Ther. 2023 Apr;57(8):918-919. PMID: 36952273
CIN - Aliment Pharmacol Ther. 2023 Apr;57(8):916-917. PMID: 36952276
MH  - Adrenal Cortex Hormones/adverse effects
MH  - *Colitis/chemically induced/diagnosis/drug therapy
MH  - *Colitis, Ulcerative/drug therapy
MH  - Gastrointestinal Agents/therapeutic use
MH  - Humans
MH  - Infliximab/adverse effects
MH  - *Neoplasms/complications
MH  - Prednisolone/therapeutic use
MH  - Retrospective Studies
MH  - Treatment Outcome
EDAT- 2022/09/20 06:00
MHDA- 2022/10/14 06:00
CRDT- 2022/09/19 22:52
PHST- 2022/05/16 00:00 [revised]
PHST- 2022/04/06 00:00 [received]
PHST- 2022/08/19 00:00 [accepted]
PHST- 2022/09/20 06:00 [pubmed]
PHST- 2022/10/14 06:00 [medline]
PHST- 2022/09/19 22:52 [entrez]
AID - 10.1111/apt.17201 [doi]
PST - ppublish
SO  - Aliment Pharmacol Ther. 2022 Nov;56(9):1370-1382. doi: 10.1111/apt.17201. Epub 
      2022 Sep 19.