Disease outcomes in immune checkpoint inhibitor colitis: A study comparing initial endoscopic and histological presentation and treatment options.

Journal of Clinical Oncology · 2025-05-28

e24083 Background: Immune-mediated diarrhea and colitis (IMDC) is a common toxicity to immune checkpoint inhibition (ICI) that is becoming increasingly common. Studies exploring the clinical course and outcomes of IMDC have been limited to relative small sample sizes ( < 200). We therefore aimed to provide a comprehensive account of the clinical, endoscopic, and histologic features of IMDC as well as the efficacy of IMDC treatment in a representative sample. Methods: This was a single-center retrospective study of all patients who received ICIs between January 2010 to February 2024 and developed IMDC. Detailed information was collected from the electronic health record regarding patient demographics, and IMDC stool biomarkers, endoscopic and histologic reports, clinical symptoms and treatment, and outcomes such as clinical symptom resolution, hospitalization, and mortality. SPSS 26.0 was used for data analysis. Results: A total of 1,151 patients were included. Patients commonly presented with diarrhea (98.3%) or abdominal pain (38.6%). Selective immunosuppressive therapy was needed in around 40% of patients, and 85% of patients were able to achieve symptom resolution. Around 40% had non-ulcerative inflammation and 23% had ulcerative inflammation, with 37% having normal macroscopic findings. Around 60% of patients had acute histological inflammation, 28% with chronic inflammation, and 11.7% with microscopic inflammation. Infliximab was associated with shorter time to clinical response and in fewer doses than vedolizumab with equal efficacy between the two medications. Conclusions: Our study is the largest to date exploring the various manifestations of IMDC as well as its treatment and outcomes. We found that its features overlap with different inflammatory colitides. Infliximab and vedolizumab are equally effective at achieving symptom remission, although infliximab has a shorter time to response. As more patients develop IMDC, larger scale studies can be carried out to validate these results.

Diabetes and the heart

Clinical Medicine · 2025-09-11 · 2 citations

Diabetes mellitus and cardiac problems frequently coexist, posing significant challenges for both generalists and specialists. This article discusses the common cardiac manifestations of diabetes including coronary artery disease, heart failure and arrythmia, outlining specific diagnostic strategies and management in people with diabetes. We also discuss specific cardiovascular risk stratification strategies in diabetes, as well as glucose-lowering therapies with potential cardiovascular benefits. Ultimately a holistic approach is needed for individuals with co-existent cardiac problems and diabetes, tailoring management strategies to specific patient needs.

O107 LONG-TERM SAFETY OF ULTRA LOW FREQUENCY WAVEFORM SHOWN IN LARGE ANIMALS

Neuromodulation Technology at the Neural Interface · 2025-01-01

Disease Outcomes in Immune-Mediated Colitis: A Study Describing Initial Endoscopic and Histologic Presentations and Treatment Options

Journal of the National Comprehensive Cancer Network · 2025-09-01 · 2 citations

BACKGROUND: Immune-mediated colitis (IMC) is a toxicity associated with immune checkpoint inhibitors (ICIs) that is becoming increasingly common. Studies exploring the clinical course and outcomes of IMC have been limited to relatively small sample sizes (<200 patients). We therefore aimed to provide a comprehensive account of the clinical, endoscopic, and histologic features of IMC as well as the efficacy of IMC treatment in a representative sample. METHODS: This was a single-center retrospective study of all patients who received ICIs at our institution between January 2010 and February 2024 and subsequently developed IMC. Detailed information was collected from the electronic health record regarding patient demographics and IMC stool biomarkers, endoscopic and histologic reports, clinical symptoms and treatment, and outcomes such as clinical symptom remission, hospitalization, and mortality. RESULTS: A total of 1,151 patients were included. Patients commonly presented with diarrhea (98.3%) or abdominal pain (38.6%). Selective immunosuppressive therapy was needed in approximately 46% of patients, and 85% achieved symptom remission. Among patients with macroscopic inflammation on endoscopy, 250 (57.6%) had nonulcerative findings, whereas 139 (32.0%) had ulceration. Among patients with histologic inflammation, approximately 60% had acute inflammation, 28% had chronic inflammation, and 12% had microscopic inflammation. Infliximab was associated with a shorter time to clinical response and required fewer doses than vedolizumab, with comparable efficacy between the 2 treatments. CONCLUSIONS: Our study represents the largest to date exploring the various manifestations of IMC, along with associated treatment approaches and outcomes. We found that its features overlap with those of different inflammatory colitides. Both infliximab and vedolizumab were equally effective in achieving symptom remission; however, infliximab was associated with a shorter time to response. As the number of patients affected by IMC continues to grow, larger-scale studies will be essential to validate and expand upon these findings.

An investigation of the effect of sex on resolution of the inflammatory response in healthy volunteers: protocol of the Resolve-Sex study

medRxiv · 2025-09-14

Abstract Background Inflammation is key in the initiation and progression of coronary artery disease (CAD). To date clinical trials testing strategies to limit inflammation have been limited by unwanted effects. Inflammatory resolution represents the active process of restoring tissue homeostasis following a pro-inflammatory response and offers a potential novel approach to limiting the inflammatory response by accelerating resolution, rather than dampening the host-defence response. Women with CAD have higher rates of morbidity and mortality compared to their male counterparts and sex differences exist in presentations, infarct patterns and plaque characteristics. The underlying reasons for these differences are not well understood. Differences in biology, in particular inflammation and the resolution of inflammation, are likely to play an important role. Our previous work has demonstrated that healthy females are more adept at resolving inflammation compared to males, although the exact mechanisms for this were unclear. In this study, we will explore the molecular mechanisms underlying resolution and particularly why this process is accelerated in females. Methods In this comparative, single centre study we will recruit 34 healthy volunteers (17 females and 17 males). A blister model of acute inflammation will be used with cantharidin applied over 3 consecutive days and blisters harvested on the fourth day. Blister fluid from 24h, 48h and 72h timepoints will be collected and analysed using several laboratory techniques including fluorophore labelled flow cytometry and cytokine analysis. The primary endpoint for the study is the comparison of the numbers of volunteers with blisters present at each time point between the sexes. In addition, blister volume, cell count and cells per ml of blister fluid at each time point will be compared between the sexes. Secondary endpoints include comparison of blister leukocyte subsets, cell death, apoptotic cells numbers, markers of blister efferocytosis, blister lactate and LDH levels. The study has a power of 80% to assess the primary endpoint. Discussion In this study we aim to identify the mechanisms involved in sex differences in the resolution of the acute inflammatory response in healthy volunteers. Trial registration ClinicalTrials.gov NCT05597098 . The study was approved by the Yorkshire &amp; The Humber – Bradford Leeds Research Ethics Committee, reference 22/YH/0244.

LONG-TERM OUTCOMES OF PATIENTS HOSPITALIZED WITH HEART FAILURE AND ATRIAL FLUTTER: THE VANCOUVER COASTAL ACUTE HEART FAILURE (VOCAL-AHF) REGISTRY

Journal of the American College of Cardiology · 2025-03-29

The association between metformin use, immune mediated colitis and overall survival in patients treated with checkpoint inhibitor

European Journal of Cancer · 2025-04-04 · 1 citations

Anatomy Primer

ACSMʼs Health & Fitness Journal · 2025-02-27 · 1 citations

ID# 1906682 Nociceptive Chronic Low Back Pain Effectively Treated with Ultra Low Frequency Neuromodulation

Neuromodulation Technology at the Neural Interface · 2025-09-23

S1529 Impact of High-Volume Crystalloid Infusion and Indomethacin Prophylaxis on Post-ERCP Pancreatitis Rates in Patients With Difficult Cannulation

The American Journal of Gastroenterology · 2024-10-01