[en] [en] BACKGROUND AND AIMS: Data regarding effectiveness and safety of JAK inhibitors and S1P receptor modulators in antibiotic refractory chronic pouchitis (CARP) are lacking.
METHODS: This ECCO-CONFER project retrospectively collected JAK inhibitors or S1P receptor modulators treatments for CARP with at least 3-months follow up. The outcomes included corticosteroid and antibiotics-free clinical response and remission at three and twelve months, trend in mPDAI, endoscopic PDAI, CRP and calprotectin.
RESULTS: Seventeen treatments in 15 patients were collected. Previous pouchitis treatments included infliximab (5/15), adalimumab (4/15), vedolizumab (9/15), and ustekinumab (5/15). Pooling data on JAK inhibitors (8 tofacitinib, 1 filgotinib and 6 upadacitinib), after 3 months (T3), steroid and antibiotics-free clinical response was achieved in 53.3% (8/15), steroid and antibiotics-free clinical remission was achieved in 40% (6/15). Of the patients with at least 12 months of follow-up, steroid and antibiotics-free clinical response was achieved in 50% (3/6) and remission in one patient (16.7%), endoscopic response in 50% (3/6), endoscopic remission in 50% (3/6). Of the two ozanimod treatments at T3, steroid and antibiotics-free clinical response was achieved in one patient, without remission; both discontinued ozanimod before T12. No side effects reported.
CONCLUSIONS: Small molecules may represent a suitable option for CARP refractory to multiple biologics, deserving further investigation.
Disciplines :
Gastroenterology & hepatology
Author, co-author :
Ribaldone, Davide Giuseppe ; Department of Medical Sciences, Division of Gastroenterology, University of Turin, Turin, Italy
Testa, Giulia; Gastroenterology-U, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
Verstockt, Bram ; Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium ; Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
Molnar, Tamas ; University of Szeged, Hungary
Savarino, Edoardo ; Division of Gastroenterology, Department of Surgery Oncology and Gastroenterology DiSCOG, University of Padova, Padova, Italy
Schmidt, Carsten; Medical Clinic II, Hospital Fulda, Fulda, Germany ; Medical Faculty of the Friedrich Schiller University, Jena, Germany
Vieujean, Sophie ; Centre Hospitalier Universitaire de Liège - CHU > > Service de gastroentérologie, hépatologie, onco. digestive
Teich, Niels ; Medical Faculty of the Friedrich Schiller University, Jena, Germany ; Gastroenterology Practice, Leipzig, Germany
Meianu, Corina; Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania ; Gastroenterology Department, Fundeni Clinical Institute, 022328 Bucharest, Romania
Juillerat, Pascal ; Clinic for Visceral Surgery and Medicine, Department of Gastroenterology, Bern University Hospital ; Crohn and Colitis Center, Gastro-enterologie Beaulieu SA, Lausanne, Switzerland
Grellier, Nathan; Hepato-Gastroenterology Department, University Hospital of Poitiers, Poitiers, France
Lobaton, Triana ; Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium, Department of Gastroenterology, University Hospital Ghent, Ghent, Belgium
Language :
English
Title :
Treatment of antibiotic refractory chronic pouchitis with JAK inhibitors and S1P receptor modulators: an ECCO CONFER Multicentre Case Series.
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