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

Shirwaikar Thomas, Anusha; Lee, Seung Eun; Shatila, Malek; De Toni, Enrico N; Török, Helga-Paula; Ben Khaled, Najib; Powell, Nicholas; Weight, Ryan et al. · Am J Gastroenterol · 2023

case_series · Level IV

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Abstract

Immune checkpoint inhibitor-mediated colitis (IMC) is commonly managed with steroids and biologics. We evaluated the efficacy of ustekinumab (UST) in treating IMC refractory to steroids plus infliximab and/or vedolizumab. Nineteen patients were treated with UST for IMC refractory to steroids plus infliximab (57.9%) and/or vedolizumab (94.7%). Most of them had grade ≥3 diarrhea (84.2%), and colitis with ulceration was present in 42.1%. Thirteen patients (68.4%) attained clinical remission with UST, and mean fecal calprotectin levels dropped significantly after treatment (629 ± 101.5 mcg/mg to 92.0 ± 21.7 mcg/mg, P = 0.0004). UST is a promising therapy for the treatment of refractory IMC.

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