Topical beclometasone dipropionate in the management of immune checkpoint inhibitor-induced microscopic colitis
File(s)
Accepted version
OA Location
Author(s)
Ibraheim, Hajir
Green, Michael
Papa, Sophie
Powell, Nick
Type
Journal Article
Abstract
Immune checkpoint inhibitors (ICPis) have revolutionised survival outcomes for cancer patients by bolstering anti-tumour immunity. However, immune activation also occurs in non-cancer tissue, and a significant proportion of patients develop immune-mediated colitis, which can be fatal if not promptly recognised and managed. Diagnosis is often made by inflammation observed during lower gastrointestinal endoscopy. Little is known about microscopic inflammation (histological findings of inflammation in the absence of overt mucosal injury). Management strategies beyond the use of systemic corticosteroids, which incur a high burden of deleterious side effects, have not been extensively explored. We describe the cases of two cancer patients with ICPi-induced colitis who had isolated histoloigical features of colitis in the absence of macroscopic disease. Sustained clinical and histological remission was induced with the topical steroid preparation, beclometasone dipropionate (Clipper), with no adverse effects.
Date Issued
2019-04-03
Date Acceptance
2019-01-25
Citation
BMJ Case Reports, 2019, 12 (4), pp.1-4
ISSN
1757-790X
Publisher
BMJ Publishing Group
Start Page
1
End Page
4
Journal / Book Title
BMJ Case Reports
Volume
12
Issue
4
Copyright Statement
© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/30948391
PII: 12/4/e226481
Subjects
immunology
inflammatory bowel disease
oncology
Administration, Topical
Aged
Anti-Inflammatory Agents
Antibodies, Monoclonal, Humanized
Antineoplastic Agents, Immunological
Beclomethasone
Colitis, Microscopic
Female
Humans
Ipilimumab
Middle Aged
Nivolumab
Treatment Outcome
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2019-04-03