Long‐term outcomes of biologic therapy for the treatment of prepouch ileitis: A multi‐centre multi‐national retrospective study
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2025
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| author | Itai Ghersin Giacomo Calini Eduard Koifman Maya Fischman Valerio Celentano Jonathan P. Segal Orestis Argyriou Simon D. McLaughlin Heather Johnson Matteo Rottoli Kapil Sahnan Janindra Warusavitarne Ailsa L. Hart |
| author_facet | Itai Ghersin Giacomo Calini Eduard Koifman Maya Fischman Valerio Celentano Jonathan P. Segal Orestis Argyriou Simon D. McLaughlin Heather Johnson Matteo Rottoli Kapil Sahnan Janindra Warusavitarne Ailsa L. Hart Itai Ghersin Giacomo Calini Eduard Koifman Maya Fischman Valerio Celentano Jonathan P. Segal Orestis Argyriou Simon D. McLaughlin Heather Johnson Matteo Rottoli Kapil Sahnan Janindra Warusavitarne Ailsa L. Hart |
| collection | Wiley Open Access |
| contents | Long‐term outcomes of biologic therapy for the treatment of prepouch ileitis: A multi‐centre multi‐national retrospective study Itai Ghersin Giacomo Calini Eduard Koifman Maya Fischman Valerio Celentano Jonathan P. Segal Orestis Argyriou Simon D. McLaughlin Heather Johnson Matteo Rottoli Kapil Sahnan Janindra Warusavitarne Ailsa L. Hart Colorectal Disease Abstract Aim Prepouch ileitis (PPI) is inflammation of the ileum proximal to an ileoanal pouch, usually associated with pouchitis. The treatment of PPI as a specific entity is poorly studied, and long‐term follow‐up data are lacking. We aimed to describe the long‐term outcomes of biologic therapy in a large, multi‐centre, multi‐national cohort of patients with PPI. Methods This was an observational, retrospective, multi‐centre, multi‐national study. We included patients with an endoscopic diagnosis of PPI, treated with biologic medications, who had a follow‐up of at least 1 year after biologic treatment initiation. The primary outcome was first‐line biologic treatment discontinuation during the study period. The secondary outcome was pouch failure, defined by the need for a defunctioning ileostomy and/or pouch excision. Results There were 71 patients in our cohort. Average follow‐up length was 101.1 months (±54.5 months). Infliximab was first‐line treatment in 42 patients (59.2%), whereas 26 (36.6%) initially received Adalimumab and 3 (4.2%) received Vedolizumab treatment. At the end of the study period, only 16/71 patients (22.5%) were still on first‐line biologic treatment. Persistence rates for infliximab (7/42, 16.7%) and adalimumab (7/26, 26.9%) were similar ( p = 0.30). Out of 55 patients discontinuing first‐line biologic treatment, 26 (36.6% of the cohort) developed pouch failure, and 29 (40.8%) are currently treated with a different medication. Conclusion First‐line biologic treatment for PPI is associated with high rates of treatment discontinuation. A significant proportion of PPI patients initially treated with biologics develop pouch failure. 10.1111/codi.70252 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| doi_str_mv | 10.1111/codi.70252 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_codi_70252 |
| institution | Wiley Open Access |
| license_str_mv | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| publishDate | 2025 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Long‐term outcomes of biologic therapy for the treatment of prepouch ileitis: A multi‐centre multi‐national retrospective study Itai Ghersin Giacomo Calini Eduard Koifman Maya Fischman Valerio Celentano Jonathan P. Segal Orestis Argyriou Simon D. McLaughlin Heather Johnson Matteo Rottoli Kapil Sahnan Janindra Warusavitarne Ailsa L. Hart Colorectal Disease Long‐term outcomes of biologic therapy for the treatment of prepouch ileitis: A multi‐centre multi‐national retrospective study Itai Ghersin Giacomo Calini Eduard Koifman Maya Fischman Valerio Celentano Jonathan P. Segal Orestis Argyriou Simon D. McLaughlin Heather Johnson Matteo Rottoli Kapil Sahnan Janindra Warusavitarne Ailsa L. Hart Colorectal Disease Abstract Aim Prepouch ileitis (PPI) is inflammation of the ileum proximal to an ileoanal pouch, usually associated with pouchitis. The treatment of PPI as a specific entity is poorly studied, and long‐term follow‐up data are lacking. We aimed to describe the long‐term outcomes of biologic therapy in a large, multi‐centre, multi‐national cohort of patients with PPI. Methods This was an observational, retrospective, multi‐centre, multi‐national study. We included patients with an endoscopic diagnosis of PPI, treated with biologic medications, who had a follow‐up of at least 1 year after biologic treatment initiation. The primary outcome was first‐line biologic treatment discontinuation during the study period. The secondary outcome was pouch failure, defined by the need for a defunctioning ileostomy and/or pouch excision. Results There were 71 patients in our cohort. Average follow‐up length was 101.1 months (±54.5 months). Infliximab was first‐line treatment in 42 patients (59.2%), whereas 26 (36.6%) initially received Adalimumab and 3 (4.2%) received Vedolizumab treatment. At the end of the study period, only 16/71 patients (22.5%) were still on first‐line biologic treatment. Persistence rates for infliximab (7/42, 16.7%) and adalimumab (7/26, 26.9%) were similar ( p = 0.30). Out of 55 patients discontinuing first‐line biologic treatment, 26 (36.6% of the cohort) developed pouch failure, and 29 (40.8%) are currently treated with a different medication. Conclusion First‐line biologic treatment for PPI is associated with high rates of treatment discontinuation. A significant proportion of PPI patients initially treated with biologics develop pouch failure. 10.1111/codi.70252 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| title | Long‐term outcomes of biologic therapy for the treatment of prepouch ileitis: A multi‐centre multi‐national retrospective study |
| topic | Colorectal Disease |
| url | https://onlinelibrary.wiley.com/doi/10.1111/codi.70252 |