Outcome of biological therapies in chronic antibiotic-refractory pouchitis: A retrospective single-centre experience.
Adalimumab
/ therapeutic use
Adult
Anti-Bacterial Agents
/ therapeutic use
Antibodies, Monoclonal, Humanized
/ therapeutic use
Biological Products
/ therapeutic use
Chronic Disease
Colitis, Ulcerative
/ surgery
Female
Gastrointestinal Agents
/ therapeutic use
Humans
Infliximab
/ therapeutic use
Male
Middle Aged
Pouchitis
/ drug therapy
Proctocolectomy, Restorative
Retrospective Studies
Treatment Failure
Treatment Outcome
Tumor Necrosis Factor Inhibitors
/ therapeutic use
Chronic pouchitis
adalimumab
biological therapy
infliximab
ulcerative colitis
vedolizumab
Journal
United European gastroenterology journal
ISSN: 2050-6406
Titre abrégé: United European Gastroenterol J
Pays: England
ID NLM: 101606807
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
04
06
2019
accepted:
24
07
2019
entrez:
9
11
2019
pubmed:
9
11
2019
medline:
9
11
2019
Statut:
ppublish
Résumé
In limited retrospective series, infliximab, adalimumab and vedolizumab have demonstrated efficacy in chronic antibiotic-refractory pouchitis. Here, we report single-centre data of all biological therapies in refractory pouchitis. We retrospectively assessed all records from patients with ulcerative colitis and ileal pouch -anal anastomosis who received infliximab, adalimumab or vedolizumab for pouchitis. Clinically relevant remission, defined as a modified Pouchitis Disease Activity Index <5 and a reduction of modified Pouchitis Disease Activity Index ≥2 points from baseline, was assessed at week 14. Thirty-three unique patients were identified. Prior to colectomy, patients had been exposed to cyclosporine ( In this case series of chronic antibiotic-refractory pouchitis, biological therapy was effective in the majority of patients and only a minority eventually required a permanent ileostomy. The use of anti-TNF agents was hampered by a high rate of adverse events, partly related to immunogenicity as some patients had been exposed to anti-TNF prior to colectomy. Vedolizumab was also efficacious and may provide a safe alternative in these chronic antibiotic-refractory pouchitis patients.
Sections du résumé
Background
In limited retrospective series, infliximab, adalimumab and vedolizumab have demonstrated efficacy in chronic antibiotic-refractory pouchitis. Here, we report single-centre data of all biological therapies in refractory pouchitis.
Methods
We retrospectively assessed all records from patients with ulcerative colitis and ileal pouch -anal anastomosis who received infliximab, adalimumab or vedolizumab for pouchitis. Clinically relevant remission, defined as a modified Pouchitis Disease Activity Index <5 and a reduction of modified Pouchitis Disease Activity Index ≥2 points from baseline, was assessed at week 14.
Results
Thirty-three unique patients were identified. Prior to colectomy, patients had been exposed to cyclosporine (
Conclusion
In this case series of chronic antibiotic-refractory pouchitis, biological therapy was effective in the majority of patients and only a minority eventually required a permanent ileostomy. The use of anti-TNF agents was hampered by a high rate of adverse events, partly related to immunogenicity as some patients had been exposed to anti-TNF prior to colectomy. Vedolizumab was also efficacious and may provide a safe alternative in these chronic antibiotic-refractory pouchitis patients.
Identifiants
pubmed: 31700634
doi: 10.1177/2050640619871797
pii: 10.1177_2050640619871797
pmc: PMC6826521
doi:
Substances chimiques
Anti-Bacterial Agents
0
Antibodies, Monoclonal, Humanized
0
Biological Products
0
Gastrointestinal Agents
0
Tumor Necrosis Factor Inhibitors
0
vedolizumab
9RV78Q2002
Infliximab
B72HH48FLU
Adalimumab
FYS6T7F842
Types de publication
Journal Article
Langues
eng
Pagination
1215-1225Informations de copyright
© Author(s) 2019.
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