继发于免疫检查点抑制剂（ICI）的免疫相关不良事件具有胃肠道表现，包括胃炎、肠炎和/或结肠炎。 ICI 相关胃肠道毒性 (GI-irAE) 的长期后遗症，特别是肠脑相互作用障碍 (DGBI) 的发展尚不清楚。我们描述了 GI-irAE 后持续性胃肠道症状的发生率。这是一项对 2013 年至 2021 年在我们机构接受 ICI 治疗并诊断为 GI-irAE 的黑色素瘤成人患者的回顾性研究。所有患者都有 GI-irAE 的内镜和组织学证据。主要结局是 GI-irAE 缓解后持续胃肠道症状（腹泻、腹痛、腹胀、便秘、大便失禁、恶心、呕吐）的发生率。风险比评估了参数与持续胃肠道症状时间之间的关联。104 名患有黑色素瘤（90% 为 IV 期疾病）且 GI-irAE 的患者符合纳入标准。 34% 接受抗 CTLA-4 治疗，33% 接受抗 PD-1 治疗，34% 接受双重治疗。患者平均接受 GI-irAE 治疗 9±6 周。 28 名 (27%) 患者在 GI-irAE 后 1.6±0.8 年出现持续性胃肠道症状。最常见的症状是便秘（17%），其次是腹胀（8%）和腹泻（5%）。超过 453 人年，事故发生率为每 100 人年 6.2%。使用 CTLA-4 单一或双重治疗与持续性胃肠道症状的风险增加 3.51 倍（95%CI 1.20-10.23）。在经历过 GI-irAE 的黑色素瘤患者队列中，26% 出现持续性胃肠道症状，最常见便秘。未来的研究应该描述 GI-irAE 后胃肠道后遗症的特征，这可能有助于阐明 DGBI 发病机制并改善癌症幸存者的生活。版权所有 © 2024 作者。由 Wolters Kluwer Health, Inc. 代表美国胃肠病学会出版。

Immune-related adverse events secondary to immune checkpoint inhibitors (ICI) have GI manifestations, including gastritis, enteritis, and/or colitis. The long-term sequelae of ICI-associated GI toxicities (GI-irAE), particularly the development of disorders of gut brain interaction (DGBI), are not well known. We characterized the incidence of persistent GI symptoms after GI-irAE.This is a retrospective study of adults with melanoma treated with ICI and diagnosed with GI-irAE at our institution from 2013-2021. All patients had endoscopic and histologic evidence of GI-irAE. The primary outcome was incidence of persistent GI symptoms (diarrhea, abdominal pain, bloating, constipation, fecal incontinence, nausea, vomiting) after resolution of GI-irAE. Hazard ratios evaluated the association between parameters and time to persistent GI symptoms.104 patients with melanoma (90% stage IV disease) and GI-irAE met inclusion criteria. 34% received anti-CTLA-4 therapy, 33% anti-PD-1, and 34% dual therapy. Patients were treated for GI-irAE for an average of 9±6 weeks. 28 (27%) patients developed persistent GI symptoms 1.6±0.8 years after GI-irAE. The most common symptom was constipation (17%), followed by bloating (8%), and diarrhea (5%). Over 453 person-years, the incident rate was 6.2% per 100 person-years. Use of CTLA-4 single or dual therapy was associated with a 3.51x risk of persistent GI symptoms (95%CI 1.20-10.23).In this cohort of melanoma patients who experienced GI-irAE, 26% developed persistent GI symptoms, most frequently constipation. Future studies should characterize the GI sequelae after GI-irAE, which may shed light on DGBI pathogenesis and improve the lives of cancer survivors.Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.