Open-Capsule Budesonide for the Treatment of Isolated Immune Checkpoint Inhibitor-Induced Enteritis.

Immune checkpoint inhibitors (ICIs) have revolutionized the management of various advanced-stage malignancies. The utilization of ICIs can be limited by their immune-related adverse events such as diarrhea and enterocolitis. Isolated ICI-induced enteritis is an uncommon presentation compared with ICI-induced colitis/enterocolitis. ICI withdrawal and systemic corticosteroids can lead to resolution of enterocolitis in up to 70% of patients. We present a rare case of isolated ICI-induced enteritis refractory to high-dose systemic corticosteroids and responsive to a course of open-capsule budesonide only.

The Impact of Inflammatory Bowel Disease Clinic On-site Vaccination Services.

Background: Despite being susceptible to vaccine-preventable diseases, patients with inflammatory bowel disease (IBD) have low vaccination rates. The aims of this study are to examine the rates of vaccine discussion and completion among patients of an IBD clinic that offers on-site vaccinations. Methods: This is a retrospective study from March 1, 2019 to February 1, 2020 comparing vaccination discussion and completion rates for patients with IBD who visited 2 clinics-1 that offers on-site vaccination (Clinic A) and 1 that does not (Clinic B). Both clinics are staffed by the same IBD physicians and utilize an identical IBD vaccine checklist. Results: A total of 356 patients were included (64.6% Crohn's, 31.7% ulcerative colitis, 1.1% indeterminate colitis, and 2.5% pouchitis). Overall vaccine discussion rate was 77.6% in Clinic A vs 70.9% in Clinic B (P = .15). Herpes zoster (HZ), pneumococcal, and tetanus-diphtheria-pertussis (Tdap) vaccine discussion rates were higher in Clinic A compared to Clinic B (17.8% vs 5%, P < .001, 56.3% vs 43.4%; P = .01, and 41.4% vs 21.4%, P < .001), respectively. Influenza vaccine completion and hepatitis A immunization rates were higher in Clinic A compared to Clinic B (67.8% vs 47.8%, P < .001 and 36.2% vs 22.5%, P = .005), respectively. A numerically higher percentage of patients completed the pneumococcal, HZ, and hepatitis B vaccination in Clinic A, but this difference did not reach statistical significance. Conclusions: IBD clinic on-site vaccination services enhanced vaccine discussion and completion rates. IBD clinics should offer on-site vaccination services as part of the comprehensive care of the IBD patient.