Authors: Li Yue Lopez Rocio Queener Elaine Shen Bo
Publish Date: 2012/12/01
Volume: 18, Issue: 12, Pages: 2232-2239
Abstract
Crohns disease CD of the pouch can develop in patients with ileal pouch–anal anastomosis resulting in significant morbidities even pouch failure The aim of this study was to evaluate short and longterm outcome of adalimumab ADA in treating these patientsA total of 48 patients who received ADA for CD of the pouch from June 2006 to June 2011 were identified from our prospectively maintained Pouchitis Registry Complete clinical response was defined as the resolution of symptoms as well as the modified Pouchitis Disease Activity Index mPDAI score being less than 5 Partial clinical response was defined as improvement in symptoms as well as a reduction in mPDAI score of 2 or more Endoscopic mucosal healing status before and after therapy was recordedAt a short followup of median 8 weeks 24 50 patients had complete response 10 21 had partial response and 14 29 had no response After a median followup of 251 months 16 33 patients had a complete response 10 21 had a partial response and 22 46 had no response At the end of the followup 13 27 patients achieved mucosal healing A total of nine 19 patients eventually developed pouch failure Patients with a longterm response had a significantly higher mucosal healing rate 609 vs 286 P = 0032 and significantly lower median mPDAI score 20 vs 50 P = 0004 at the first followup evaluation than those with no longterm response Multivariate analysis showed concurrent endoscopic stricture dilation hazard ratio = 59 95 confidence interval 16 212 increased the chance for the longterm response to ADA One patient developed multiple sclerosis during the therapy
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