Efficacy of infliximab rescue therapy in patients with chronic refractory pouchitis: A multicenter study
Article first published online: 8 AUG 2011
Copyright © 2011 Crohn's & Colitis Foundation of America, Inc.
Inflammatory Bowel Diseases
Volume 18, Issue 5, pages 812–817, May 2012
How to Cite
Acosta, M. B.-d., García-Bosch, O., Souto, R., Mañosa, M., Miranda, J., García-Sanchez, V., Gordillo, J., Chacon, S., Loras, C., Carpio, D., Maroto, N., Menchén, L., Rojas-Feria, M., Sierra, M., Villoria, A., Marin-Jimenez, I. and on behalf of Grupo joven GETECCU (2012), Efficacy of infliximab rescue therapy in patients with chronic refractory pouchitis: A multicenter study. Inflamm Bowel Dis, 18: 812–817. doi: 10.1002/ibd.21821
- Issue published online: 12 APR 2012
- Article first published online: 8 AUG 2011
- Manuscript Received: 10 JUN 2011
- Manuscript Accepted: 10 JUN 2011
- rescue therapy;
- chronic refractory pouchitis
Despite medical therapy, 30% of patients with ulcerative colitis (UC) need to undergo surgery. Around 50% of patients with proctocolectomy with ileal pouch–anal anastomosis (IPAA) develop complications of the pouch. Clinical evidence for the use of infliximab (IFX) in refractory pouchitis is limited. The aim of this study was to report efficacy of IFX in these patients.
A retrospective, multicenter study was designed. Patients older than 18 years with chronic refractory pouchitis treated with IFX (5 mg/kg) were included. Short-term IFX efficacy was evaluated at week 8 and mid-term efficacy at weeks 26 and 52. Complete response was defined as cessation of diarrhea and urgency and partial response as marked clinical improvement but persisting symptoms. The modified Pouchitis Disease Activity Index (mPDAI) without endoscopy was calculated when available.
Thirty-three consecutive UC patients with chronic refractory pouchitis were included (18 male, mean age 45 years, range 21–67). At week 8, 21% patients achieved complete response and 63% showed partial clinical response. At weeks 26 and 52, 33% and 27% achieved complete response and 33% and 18% showed partial clinical response, respectively. Thirteen patients (39%) withdrew treatment (four for lack of efficacy, four for loss of response and five for adverse events). None of the potential factors analyzed had an influence on response to IFX.
IFX was effective in the short- and mid-term in patients with chronic refractory pouchitis. However, medication had to be discontinued in a high number of patients. (Inflamm Bowel Dis 2011;)