Infliximab to Treat Refractory Inflammation After Pelvic Pouch Surgery for Ulcerative Colitis

Abstract

Infliximab can effectively treat inflammatory pouch complications. Pre-treatment mPDAI <10 and early endoscopy may identify responders.

Increase in chromogranin A- and serotonin-positive cells in pouch mucosa of patients with ulcerative colitis undergoing proctocolectomy

“…We then measured TpH-1 and SERT expression in the pouch biopsies cultured ex vivo with infliximab, an anti-TNF-α monoclonal antibody that has been demonstrated to exert a therapeutic effect on patients with pouchitis. 33 Nonetheless, infliximab did not modify TpH-1 and SERT levels. In order to validate our ex vivo experiments, in the biopsy culture supernatants we detected IL-6, a cytokine of the innate immunity, and IL-8, a chemokine, known to be increased in pouch mucosa.…”

Updated S3-Guideline Ulcerative Colitis. German Society for Digestive and Metabolic Diseases (DGVS)

“…Post-induction response was achieved in 74 % and long-term response in 62.6 %. Mean PDAI and CRP values showed a statistically significant decrease under therapy [668].…”

Pouchitis in inflammatory bowel disease: a review of diagnosis, prognosis, and treatment

“…Two double-blind, placebo-controlled studies have demonstrated that VSL#3 is effective to maintain remission after induction with combination antibiotic therapies. 65,66 If a combination of oral antibiotics fail to induce or maintain remission, oral or topical mesalamine, corticosteroids, 67 anti-TNF drugs including infliximab [68][69][70][71] and adalimumab 72,73 are shown to be effective for chronic pouchitis. 74,75 According to a recent meta-analysis regarding the efficacy of anti-TNF therapy on chronic refractory pouchitis, the rates of short-term (8 weeks) and long-term (12 months) clinical remission were 0.10 (95% CI, 0.00-0.35) and 0.37 (95% CI, 0.14-0.62), respectively.…”