Immune checkpoint inhibitors (ICI) cause acute gastrointestinal (GI) immune-related adverse events (IrAEs). We aimed to report and describe chronic GI IrAEs. We included consecutive patients addressed to a single center between October 2010 and March 2022 for endoscopic and/or histological GI inflammation persisting at least six months after the last dose of ICI. Among a total of 178 patients addressed for GI IrAE, 14 met the inclusion criteria (8 %). The median follow-up was 13 months after discontinuation of ICI. The most common symptom was watery diarrhea (54 %). Ten (77 %) patients had colonic involvement and three patients (21 %) had ileal involvement. Ten patients (77 %) had inflammatory lesions, two patients (15 %) had fistulas and one patient had (8 %) a stricture. All patients had lymphoplasmacytic infiltrate and basal plasmacytosis, and seven (54 %) had crypt distortions. Nine patients (69 %) received medical therapy, including five patients treated with vedolizumab, two patients (15 %) underwent intestinal resection. At the last follow-up, seven of the 13 patients were receiving maintenance therapy. Endoscopic lesions persisted one year after discontinuing ICI in 4/6 patients, and two years after discontinuation in 3/4 patients. Chronic GI IrAEs exist after ICI use.

中文翻译：

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暴露于免疫检查点抑制剂的患者的慢性胃肠道免疫相关不良事件

免疫检查点抑制剂 (ICI) 会导致急性胃肠道 (GI) 免疫相关不良事件 (IrAE)。我们的目的是报告和描述慢性胃肠道 IrAE。我们纳入了 2010 年 10 月至 2022 年 3 月期间因内镜和/或组织学胃肠道炎症在最后一剂 ICI 后持续至少六个月而前往单一中心的连续患者。在总共 178 名接受 GI IrAE 治疗的患者中，14 名患者符合纳入标准 (8%)。中位随访时间为 ICI 终止后 13 个月。最常见的症状是水样腹泻（54%）。 10 名患者（77%）有结肠受累，3 名患者（21%）有回肠受累。十名患者（77%）有炎性病变，两名患者（15%）有瘘管，一名患者（8%）有狭窄。所有患者均出现淋巴浆细胞浸润和基础浆细胞增多，其中 7 例 (54%) 出现隐窝扭曲。 9 名患者（69%）接受了药物治疗，其中 5 名患者接受了维多珠单抗治疗，两名患者（15%）接受了肠切除术。在最后一次随访时，13 名患者中有 7 名正在接受维持治疗。 4/6 患者中止 ICI 后内镜损伤持续存在，3/4 患者中止 ICI 后两年内镜病变持续存在。使用 ICI 后存在慢性胃肠道 IrAE。