Efficacy of Anti-TNF Antibodies in the Treatment of Pouchitis: A Report of 3 Cases

Kataria, Archish; Randall, Charles

doi:10.14309/00000434-201610001-01737

Cited by 1 publication

(3 citation statements)

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“…There is limited data about the use of golimumab, but the case series presented by Kataria and colleagues showed a 100% initial and sustained complete response in 2 patients with CARP. 53 The overall rate of adverse events was 16.2% for IFX, most of which were infusion reactions in patients that presented an allergic reaction to TNF alpha inhibitors previous to the creation of the IPAA, 6.1% in adalimumab and 7.6% for vedolizumab. Neither studies that used UST nor golimumab reported any adverse events.…”

Section: Discussionmentioning

confidence: 94%

“…When comparing biologics, IFX had a higher rate of complete response in CARP, this difference was statistically significant when compared with vedolizumab ( P =0.05) but not when compared with UST ( P =0.95). There is limited data about the use of golimumab, but the case series presented by Kataria and colleagues showed a 100% initial and sustained complete response in 2 patients with CARP 53 . The overall rate of adverse events was 16.2% for IFX, most of which were infusion reactions in patients that presented an allergic reaction to TNF alpha inhibitors previous to the creation of the IPAA, 6.1% in adalimumab and 7.6% for vedolizumab.…”

Section: Discussionmentioning

confidence: 99%

“…The patient receiving adalimumab achieved remission after the second maintenance round and was still in remission after 1 year. However, that subject experienced a clinical relapse at 18-month follow-up 53 …”

Section: Effects Of Biologicsmentioning

confidence: 98%

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Use of Biologics for the Treatment of Inflammatory Conditions of the Pouch

Godoy-Brewer

Salem

Limketkai

et al. 2023

Journal of Clinical Gastroenterology

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Background: Patients with medically-refractory ulcerative colitis or advanced neoplasia are often offered an ileal-pouch-anal anastomosis to restore bowel continuity. However, up to 50% of patients can suffer from inflammatory conditions of the pouch, some of which require biological therapy to treat. The aim of this study was to determine the efficacy of each biological agent for the treatment of inflammatory conditions of the pouch. Materials and Methods:A comprehensive literature search was performed in the major databases from inception through February 11, 2020, for studies assessing the efficacy of biologics in chronic antibiotic-refractory pouchitis (CARP) and Crohn's disease (CD) of the pouch. Both prospective and retrospective studies were included. The primary outcomes of interest were complete and partial responses were defined within each study. χ 2 test was used to compare variables.Results: Thirty-four studies were included in the systematic review and meta-analysis. Sixteen studies (N = 247) evaluated the use of infliximab (IFX), showing complete response in 50.7% and partial response in 28.1% for CARP, and complete response in 66.7% and partial response in 20% for CD of the pouch. Seven studies (n = 107) assessed the efficacy of adalimumab. For CARP, 33.3% of patients had a complete response, and 38.1% had a partial response, whereas for CD of the pouch, 47.7% experienced a complete response, and 24.6% had a partial response. Three studies (n = 78) reported outcomes with the use of ustekinumab, showing 50% complete response and 3.8% partial response for CARP. For the CD of the pouch, 5.8% had a complete response and 78.8% had a partial response. Seven studies (n = 151) reported the efficacy of vedolizumab, showing 28.4% complete response and 43.2% partial response in patients with CARP, whereas 63% of patients experienced partial response in CD of the pouch. IFX had higher rates of complete response in CARP compared with adalimumab (P = 0.04) and compared with vedolizumab (P = 0.005), but not compared with ustekinumab (P = 0.95). There were no new safety signals reported in any of the studies.Conclusions: Biologics are safe and efficacious in the treatment of chronic, refractory inflammatory conditions of the pouch. IFX seems to be more efficacious than adalimumab and vedolizumab for CARP. Further prospective, head-to-head evaluations are needed to compare biological therapies in the treatment of CARP and CD of the pouch.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%