TY - JOUR
T1 - Immune Checkpoint Inhibitor Enterocolitis vs Idiopathic Inflammatory Bowel Disease
AU - Shirwaikar Thomas, Anusha
AU - Hanauer, Stephen
AU - Wang, Yinghong
N1 - Funding Information:
Anusha Shirwaikar Thomas and Yinghong Wang conceptualized the manuscript, reviewed the available literature, ensured that accuracy and integrity were preserved at all stages, agreed to be accountable for all aspects of the study, contributed to the writing of the manuscript, with input from all authors. Stephen Hanauer contributed to reviewing and writing the manuscript and providing expert feedback and input. All authors read and approved the final manuscript. The authors disclose no conflicts.
Publisher Copyright:
© 2023 AGA Institute
PY - 2023/4
Y1 - 2023/4
N2 - Immune checkpoint inhibitors have revolutionized management of advanced malignancies. However, their use is frequently complicated by immune related adverse events (irAEs), immune checkpoint inhibitor enterocolitis (IMEC) being the most common toxicity. IMEC is a distinct form of bowel inflammation that is highly reminiscent of idiopathic inflammatory bowel disorders (Crohn's disease, ulcerative colitis, and microscopic colitis). In this review, we highlight the similarities and differences in the pathophysiology, clinical presentation, evaluation, and management of these overlapping immune inflammatory bowel disorders. IMEC is an inflammatory bowel disease–like irAE that occurs as an outcome of disruption of intestinal immune surveillance and gut dysbiosis. Clinical and endoscopic presentation of both entities is strikingly similar, which often guides management. Though well established in inflammatory bowel disease, little is known about the long term outcomes of IMEC.
AB - Immune checkpoint inhibitors have revolutionized management of advanced malignancies. However, their use is frequently complicated by immune related adverse events (irAEs), immune checkpoint inhibitor enterocolitis (IMEC) being the most common toxicity. IMEC is a distinct form of bowel inflammation that is highly reminiscent of idiopathic inflammatory bowel disorders (Crohn's disease, ulcerative colitis, and microscopic colitis). In this review, we highlight the similarities and differences in the pathophysiology, clinical presentation, evaluation, and management of these overlapping immune inflammatory bowel disorders. IMEC is an inflammatory bowel disease–like irAE that occurs as an outcome of disruption of intestinal immune surveillance and gut dysbiosis. Clinical and endoscopic presentation of both entities is strikingly similar, which often guides management. Though well established in inflammatory bowel disease, little is known about the long term outcomes of IMEC.
KW - Adverse Events
KW - Immune Checkpoint Inhibitor
KW - Inflammatory Bowel Disease
UR - http://www.scopus.com/inward/record.url?scp=85146636941&partnerID=8YFLogxK
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U2 - 10.1016/j.cgh.2022.10.004
DO - 10.1016/j.cgh.2022.10.004
M3 - Review article
C2 - 36270617
AN - SCOPUS:85146636941
SN - 1542-3565
VL - 21
SP - 878
EP - 890
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
IS - 4
ER -