Incidence and risk factors of immune checkpoint inhibitor-induced colitis in Korean patients with cancer

Korean J Intern Med. 2025 Jan;40(1):49-56. doi: 10.3904/kjim.2024.135. Epub 2025 Jan 1.

Abstract

Background/aims: Immune checkpoint inhibitors (ICIs) are effective in treating cancer. However, various immune-related adverse events (irAEs) have become prevalent, with ICI-induced colitis being the most common gastrointestinal irAE. Thus, we aimed to investigate the incidence and risk factors of ICI-induced colitis in Korean patients with cancer.

Methods: This retrospective study included patients treated with ICIs between October 2015 and June 2022 in two tertiary referral centers in Daegu, Korea. The incidence of ICI-induced colitis was determined using electronic medical records. Risk factors for ICI-induced colitis were identified using univariate and multivariate logistic regression analyses.

Results: We included 1,478 patients with ICI-treated cancer. The incidence of ICI-induced colitis was 3.5% (n = 52/1,478). Multivariate logistic regression analysis showed that the combination of nivolumab and ipilimumab was a risk factor for ICI-induced colitis (p = 0.006; odds ratio, 9.768; 95% confidence interval, 1.93-49.30).

Conclusion: ICI-induced colitis had an incidence rate of 3.5% and was associated with the combination of nivolumab and ipilimumab. Most patients with ICI-induced colitis developed mild symptoms that improved with supportive care alone, making ICI therapy resumption possible.

Keywords: Colitis; Immune checkpoint inhibitors.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Colitis* / chemically induced
  • Colitis* / epidemiology
  • Colitis* / immunology
  • Female
  • Humans
  • Immune Checkpoint Inhibitors* / adverse effects
  • Incidence
  • Ipilimumab / adverse effects
  • Male
  • Middle Aged
  • Neoplasms* / drug therapy
  • Neoplasms* / epidemiology
  • Nivolumab / adverse effects
  • Republic of Korea / epidemiology
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors

Substances

  • Immune Checkpoint Inhibitors
  • Ipilimumab
  • Nivolumab