Vitamin D may protect against colitis adverse events in patients taking immune checkpoint inhibitors

Research has suggested that people who take vitamin D supplements at initiation of treatment for melanoma have a reduced risk of developing colitis compared with those who do not.

Vitamin D

People with melanoma who take immune checkpoint inhibitors (ICIs) are less likely to develop colitis if they are taking vitamin D supplements at treatment initiation, a study published in the journal Cancer (22 June 2020) has suggested[1]
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Researchers analysed data on 213 patients treated for melanoma with nivolumab and/or ipilimumab, or pembrolizumab between May 2011 and October 2017, 37 of whom developed ICI colitis. 

The team found that 34.1% of patients without colitis reported taking a vitamin D supplement at the time of treatment initiation, compared with 16.2% of patients with colitis.

In multivariate analysis, patients who were taking vitamin D supplements before initiating treatment had reduced odds of developing colitis (odds ratio [OR] 0.35; 95% confidence interval [CI] 0.1–0.9) compared with patients who were not taking vitamin D.

Vitamin D deficiency and immune dysregulation have been linked to the development of autoimmune colitis, but predictive markers for ICI-induced colitis are lacking, the researchers explained. They added that, to their knowledge, this was the first study to identify vitamin D as a protective factor against the development of ICI colitis.

“These results may suggest benefit in prophylactic use of vitamin D supplementation to prevent ICI colitis, as previously demonstrated in inflammatory bowel disease and graft-versus-host disease,” they concluded.

References

[1] Grover S, Dougan M, Tyan K, et al. Vitamin D intake is associated with decreased risk of immune checkpoint inhibitor-induced colitis. Cancer 2020. doi: 10.1002/cncr.32966

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Citation
The Pharmaceutical Journal, July 2020;Online:DOI:10.1211/PJ.2020.20208172