Posted on 04/02/2023 6:50:09 PM PDT by ConservativeMind
A new study has found vedolizumab can induce remission in patients who have chronic pouchitis after surgery for ulcerative colitis.
Twelve percent of people with ulcerative colitis need surgery to have their colon removed (colectomy). Most of those have an ileo-anal pouch surgically constructed from their small bowel, which means that they don't have to live with a stoma bag. Sadly, after surgery there is a risk of inflammation developing in the lining of the pouch, a condition known as pouchitis. Antibiotics are the first line treatment to reduce the inflammation, but one fifth will go on to develop chronic, antibiotic-refractory pouchitis.
Simon Travis ran an international randomized trial to evaluate the effect of vedolizumab on chronic pouchitis.
Professor Travis explained, "Vedolizumab is widely used for treating ulcerative colitis and this study shows that it is effective for pouchitis that recurs rapidly or persists in spite of antibiotics. Vedolizumab has become the first treatment in Europe licensed for pouchitis that does not respond to antibiotics. That's a game changer for these patients."
The trial randomized 102 adults who had developed chronic pouchitis after colectomy. Half the patients were assigned to receive 300mg of vedolizumab, the other half a placebo, administered at day 1, and weeks 2, 6, 14, 22 and 30. Both groups also received ciprofloxacin from weeks one to four.
The study team measured remission at week 14, based on the modified Pouchitis Disease Activity Index (mPDAI) that includes symptoms and endoscopy. Those patients receiving vedolizumab were three times more likely to achieve remission ay week 14 than those receiving placebo. A significant difference was found in key secondary endpoints, such as remission at week 34, remission defined by the full PDAI (which includes histology), sustained remission (at both week 14 and week 34) and quality of life.
(Excerpt) Read more at medicalxpress.com ...
CM, thanks for posting this. DX’d with UC 29 years ago. It’s currently flaring up- my GI doc said it would after my liver transplant. Went to see him this morning, and along with my anti-rejection meds and my current colitis meds, he put me back on prednisone. The option of removing my colon, while not likely at this point, is always at the back of my mind. I’m filing this info away for another time, and hopefully, I won’t need it.👍
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