A Case of Ipilimumab-induced Anorectal Fistula (vol 10, pg 501, 2016)

Dear Sir,Ipilimumab (Yervoy®) is a human monoclonal antibody (anti-CTLA4) approved since 2011 by the FDA for the treatment of unresectable or metastatic melanoma. This drug is associated with autoimmune side effects affecting the gut, liver, skin, endocrine organs and nerves. Thirty-five percent of patients treated with ipilimumab will develop colitis, and 10% of these cases can evolve to a colonic perforation requiring surgical management.1,2 Ipilimumab-induced colitis shares immune and histological patterns with Crohn’s disease.3 Steroids are generally the first-line treatment to deal with this type of colitis, but anti-tumour necrosis factor α (TNFα) drugs have been used in …