S310 Fecal Transplantation Improved Patients’ Reported Outcome After Immune Checkpoint Inhibitor Colitis

作者：Yinghong Wang, Malek Shatila, Krishnavathana Varatharajalu, Carolina Colli Cruz, Shu‐En Shen, Mary Herrera, X. Wang, Anusha Shirwaikar Thomas, Herbert L. DuPont · 发表于：The American Journal of Gastroenterology · 年份：2024 · DOI：10.14309/01.ajg.0001030608.87316.36 · 被引用次数：5 · 研究领域：Renal Transplantation Outcomes and Treatments、Clinical Nutrition and Gastroenterology、Microscopic Colitis

Introduction: Fecal microbiota transplantation (FMT) is effective for recurrent Clostridioides difficile infections (CDI). FMT has seen its application extended to other gastrointestinal disorders. Immune-mediated colitis (IMC) arises as a side effect of immune checkpoint inhibitor (ICI) therapy. Treatment of IMC is mostly limited to immunosuppressants, however refractory cases pose a significant challenge. FMT has been shown to be a successful treatment in refractory IMC in small case series, further large studies are needed to determine its efficacy. Methods: We measured the efficacy of FMT for refractory IMC among 62 patients via chart review and clinical assessment and patients’ reported outcome (PRO) via established MD Anderson Symptom Inventory (MDASI). Among them, 9 patients had concurrent CDI as well at the time of diagnosis. Results: Sixty-two patients were included in our study. Most patients had a peak diarrhea grade ≥ 3 (93.5%) and colitis grade ≥ 2 (87.1%). Ulcerous (29, 46.8%) and non-ulcerous (16, 25.8%) inflammation were the predominant endoscopic findings. Sixty (96.7%) patients received corticosteroids, and 58 patients (93.5%) received add-on infliximab or vedolizumab. IMC symptom response was 80.6% after FMT with median time to response of 5 days. The transient complication rate is 37% at 7 days and 27.4% at 30 days. Response rate among the 53 patients without concurrent CDI was 81.1%. Fifty (80.6%) patients demonstrated clinical remission by the end of the...