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开放胶囊型布地奈德治疗孤立性免疫检查点抑制剂诱导的肠炎。

Open-Capsule Budesonide for the Treatment of Isolated Immune Checkpoint Inhibitor-Induced Enteritis.

作者信息

Hussain Nadeen, Robert Marie, Al-Bawardy Badr

机构信息

Department of Internal Medicine, Yale School of Medicine, New Haven, CT.

Department of Pathology, Yale School of Medicine, New Haven, CT.

出版信息

ACG Case Rep J. 2022 Oct 7;9(10):e00882. doi: 10.14309/crj.0000000000000882. eCollection 2022 Oct.

DOI:10.14309/crj.0000000000000882
PMID:36237281
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9553371/
Abstract

Immune checkpoint inhibitors (ICIs) have revolutionized the management of various advanced-stage malignancies. The utilization of ICIs can be limited by their immune-related adverse events such as diarrhea and enterocolitis. Isolated ICI-induced enteritis is an uncommon presentation compared with ICI-induced colitis/enterocolitis. ICI withdrawal and systemic corticosteroids can lead to resolution of enterocolitis in up to 70% of patients. We present a rare case of isolated ICI-induced enteritis refractory to high-dose systemic corticosteroids and responsive to a course of open-capsule budesonide only.

摘要

免疫检查点抑制剂（ICI）彻底改变了各种晚期恶性肿瘤的治疗方式。ICI的应用可能会受到腹泻和小肠结肠炎等免疫相关不良事件的限制。与ICI诱导的结肠炎/小肠结肠炎相比，孤立性ICI诱导的小肠炎并不常见。停用ICI和全身性皮质类固醇可使高达70%的患者的小肠结肠炎得到缓解。我们报告了一例罕见的孤立性ICI诱导的小肠炎病例，该病例对高剂量全身性皮质类固醇难治，仅对一个疗程的开放胶囊布地奈德有反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd07/9553371/5424121f06a2/ac9-9-e00882-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd07/9553371/e42d71eb0f0e/ac9-9-e00882-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd07/9553371/ce7aed82605d/ac9-9-e00882-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd07/9553371/71c28c6fc6e8/ac9-9-e00882-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd07/9553371/5424121f06a2/ac9-9-e00882-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd07/9553371/e42d71eb0f0e/ac9-9-e00882-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd07/9553371/ce7aed82605d/ac9-9-e00882-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd07/9553371/71c28c6fc6e8/ac9-9-e00882-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd07/9553371/5424121f06a2/ac9-9-e00882-g004.jpg

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J Immunother. 2021 Oct 1;44(8):325-334. doi: 10.1097/CJI.0000000000000383.
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Immune Checkpoint Inhibitors for the Treatment of Cancer: Clinical Impact and Mechanisms of Response and Resistance.免疫检查点抑制剂在癌症治疗中的应用：临床影响及反应和耐药的机制。
Annu Rev Pathol. 2021 Jan 24;16:223-249. doi: 10.1146/annurev-pathol-042020-042741. Epub 2020 Nov 16.
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AGA Clinical Practice Update on Diagnosis and Management of Immune Checkpoint Inhibitor Colitis and Hepatitis: Expert Review.
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Support Care Cancer. 2024 Sep 23;32(10):680. doi: 10.1007/s00520-024-08889-2.
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