High Rehospitalization and Mortality Rates Persist After ICI-Associated Colitis

Immune checkpoint inhibitor (ICI)–associated colitis is linked to substantial morbidity even after therapy discontinuation, with high rates of rehospitalization and mortality, according to a large real-world analysis using the TriNetX Research Network. The findings highlight the need for closer post-treatment monitoring and standardized management strategies.

Investigators identified 17,353 adults who developed ICI-associated colitis, defined by diagnostic codes and treatment patterns. The cohort had a mean age of 64.6 years and a high burden of comorbidities, including ischemic heart disease, diabetes, and chronic kidney disease. Nearly all patients (96%) required corticosteroids, reflecting clinically significant disease severity, while use of biologic rescue therapy was limited.

Adverse outcomes remained frequent after ICI discontinuation. Rehospitalization occurred in 25% of patients within 30 days, increasing to 43% by 180 days. Intensive care unit admissions rose from 6% to 12% over the same period, and mortality increased from 7% at 30 days to 23% at 180 days. Colectomy was uncommon but occurred in a small subset, indicating refractory disease.

The authors reported that “ICI colitis is linked to significant morbidity, evidenced by high rates of rehospitalization, ICU use, and death.” 

These findings suggest that clinical resolution of acute colitis does not necessarily translate into sustained recovery. Ongoing inflammation, treatment-related complications, or underlying comorbidities may contribute to prolonged risk.

Reference
Alekhya Mannava, Jaime Perez, Preetika Sinh, et al. Immune checkpoint inhibitor colitis: a us-based collaborative network propensity-matched cohort study of rehospitalization and outcomes after ICI therapy discontinuation. Presented at: Digestive Disease Week; May 2–5, 2026; Chicago, Illinois.