Evidence map›Paper›PMID 36339292›Full record

ArticleDrugs in context2022

Small bowel villous atrophy due to immune-checkpoint inhibitors: report of two cases and literature review.

Annalisa Schiepatti, Andrea Premoli, Stiliano Maimaris, Mimma Rizzo, Maria Marples, Laura Villani, Nigel Scott, Federico Sottotetti, David S Sanders, Federico Biagi and 1 more

Open access · goldAbstract readCase Reports
In one paragraph

Article in Drugs in context, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
2.1field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 15 citations in OpenAlex.

  1. Guideline
  2. Guideline
  3. Article
  4. Review
  5. Article
  6. Non-celiac Enteropathies.Current gastroenterology reports · 2025
    Review
  7. Review
  8. Immune checkpoint inhibitor-induced diarrhea and colitis: an overview.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024
    Review
  9. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 2 countries.

Annalisa SchiepattiDipartimento di Medicina Interna e Terapia Medica, University of Pavia, Pavia, Italy.
Andrea PremoliIstituti Clinici Scientifici Maugeri, IRCCS, Division of Translational Oncology, Pavia, Italy.
Stiliano MaimarisDipartimento di Medicina Interna e Terapia Medica, University of Pavia, Pavia, Italy.
Mimma RizzoIstituti Clinici Scientifici Maugeri, IRCCS, Division of Translational Oncology, Pavia, Italy.
Maria MarplesDepartment of Oncology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Laura VillaniIstituti Clinici Scientifici Maugeri, IRCCS, Pathology Unit of Pavia Institute, Maugeri Hospital of Pavia, Pavia, Italy.
Nigel ScottDepartment of Histopathology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Federico SottotettiIstituti Clinici Scientifici Maugeri, IRCCS, Division of Translational Oncology, Pavia, Italy.
David S SandersAcademic Department of Gastroenterology, Royal Hallamshire Hospital, Sheffield, UK.
Federico BiagiDipartimento di Medicina Interna e Terapia Medica, University of Pavia, Pavia, Italy.
Clare DonnellanLeeds Gastroenterology Institute, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Istituti Clinici Scientifici Maugeri · ITLeeds Teaching Hospitals NHS Trust · GBUniversity of Pavia · ITRoyal Hallamshire Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The differential diagnosis of non-coeliac enteropathies (NCEs) is challenging and includes a wide range of aetiologies. Drug-induced NCEs are relatively common and characterized by duodenal villous atrophy, which resolves upon suspension of the offending drug. Immune-checkpoint inhibitors (ICIs), targeting molecules involved in the activation of cytotoxic T cells by targeting, for example, PD-1, PD-L1 and CTLA4, are increasingly used for many types of cancers. Adverse events occurring in the gastrointestinal tract have been described, predominantly in the form of immune-mediated colitis mimicking inflammatory bowel disease. Small bowel involvement whilst on ICI therapy is also possible, though less well described. Herein, we describe two cases of enteropathy with villous atrophy and negative coeliac serology due to ICIs: a 65-year-old man affected by stage IV pulmonary adenocarcinoma under treatment with pembrolizumab and an 18-year-old woman affected by stage IV auricular melanoma who was treated with nivolumab. We also provide a review of the current literature describing small bowel involvement during therapy with ICIs, alone or in combination, for different types of solid tumours. Implications for clinical practice include considering the possibility of small bowel involvement in oncological patients treated with ICIs and the inclusion of ICIs amongst the iatrogenic causes of NCE with villous atrophy. Enteropathies due to ICIs may also represent a pathogenetic model for the understanding of the molecular mechanisms leading to villous atrophy in NCE.

Indexed as

immune-checkpoint inhibitorsmalabsorptionnon-coeliac enteropathyvillous atrophy

Identifiers

PMID36339292
PMCPMC9616105
OpenAlexW4306783242

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.