P3653 - A Case Series: Nintedanib Induced Colitis Mimicking Inflammatory Bowel Disease

Tarek Odah, MD, Christian Karime, MD, Jana G.. Hashash, MD, MSc, FACG, Francis A. Farraye, MD, MSc, MACG
Mayo Clinic, Jacksonville, FL

Introduction: Nintedanib (Ofev) was approved by the FDA in October 2014 for treatment of idiopathic pulmonary fibrosis among other conditions. Nintedanib can cause a wide range of gastrointestinal adverse events. We describe four cases of Nintedanib-induced colitis.

Case Description/Methods: Between January 2017 and February 2023, four patients with Nintedanib-induced colitis were identified (Table 1). The average age was 69 years, 50% were male and all patients were White. All patients presented with nausea, vomiting and diarrhea while three had anorexia and weight loss, and two patients had abdominal pain. All patients had a normal white blood cell count. Of the 4 patients, 3 had stool studies negative for an infectious etiology. CT scan of abdomen and pelvis showed pancolitis in two patients, right sided colitis in one and left sided colitis in one. Endoscopic evidence of colitis was seen in two patients. Pathologic findings are included in the table below. Three of the four patients discontinued Nintedanib with documented improvement in their symptoms while the fourth patient remained on Nintedanib and expired several weeks later.

Discussion: Nintedanib is an approved medication that has been increasingly used in the last few years for treatment of idiopathic and progressive pulmonary fibrosis. Our case series describes four patients with colitis symptoms associated with Nintedanib use. Discontinuing Nintedanib in three out of the four patients resulted in resolution of the patient’s symptoms while the fourth patient elected to remain on this medication. Budesonide decreased symptoms in one patient. Clinicians should be vigilant in taking a history and including Ninteadnib as a cause for gastrointestinal symptoms including colitis.


Disclosures:


Tarek Odah, MD, Christian Karime, MD, Jana G.. Hashash, MD, MSc, FACG, Francis A. Farraye, MD, MSc, MACG. P3653 - A Case Series: Nintedanib Induced Colitis Mimicking Inflammatory Bowel Disease, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.