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BMJ Case Reports 2016; doi:10.1136/bcr-2016-216641
  • CASE REPORT

Vedolizumab: a novel treatment for ipilimumab-induced colitis

  1. Jane M Andrews2
  1. 1Department of Medical Oncology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
  2. 2Department of Gastroenterology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
  1. Correspondence to Dr Amy Hsin-Chieh Hsieh, hsinchiehamy.hsieh{at}sa.gov.au
  • Accepted 2 August 2016
  • Published 18 August 2016

Summary

Use of the immune checkpoint inhibitors, ipilimumab and nivolumab, has revolutionised treatment in patients with metastatic melanoma. However, these drugs can cause an autoimmune enterocolitis, with diarrhoea as the presenting symptom. This is conventionally managed by prompt institution of corticosteroid therapy if moderate diarrhoea (3–6 times/day; grade 2) is present for >5 days or if diarrhoea is severe (>6 times/day; grade 3). We report a case of steroid-dependent ipilimumab-induced colitis successfully treated with vedolizumab (an inhibitor of memory T-cell trafficking to the gut), after which complete withdrawal of corticosteroid was achieved. Hence, vedolizumab warrants further evaluation as a potential novel treatment of ipilimumab-induced colitis.

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