Vedolizumab for treatment of chronic refractory pouchitis: a systematic review with pool analysis

• Davide Giuseppe Ribaldone ^[1] ; Rinaldo Pellicano ^[2] ; Giorgio Maria Saracco ^[1] ; Mario Morino ^[1] ; Marco Astegiano ^[2]
  1. [1] Università di Torino. Turin, Italy
  2. [2] Ospedale Molinette. Turin, Italy
• Localización: Revista Española de Enfermedades Digestivas, ISSN-e 2340-4167, ISSN 1130-0108, Vol. 112, Nº. 1, 2020, págs. 59-63
• Idioma: inglés
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• Resumen

  • Background and objectives: about 1%-2% of patients with chronic refractory pouchitis, in the context of ulcerative colitis, end up with a permanent ileostomy. The aim of this systematic review was to collect all published studies involving patients treated with vedolizumab for chronic refractory or antibiotic-dependent pouchitis and then pool the data regarding the effectiveness of this therapeutic strategy. Methods: a MEDLINE and Web of Science search of all studies published in English until March 17, 2019 was conducted using the terms “vedolizumab and pouchitis”. Results: seven studies with a total of 44 patients with chronic pouchitis were included. Twenty-three out of 44 patients (52.3%) had undergone previous treatment with anti-tumor necrosis factor (TNF) drugs. At week 12, 33 out of 44 patients (75%) reported clinical improvement. Endoscopic improvement, evaluated within 6 months of the start of vedolizumab therapy, was obtained in 28 out of the 38 patients in whom such data were available (73.7%). Conclusions: this first systematic review published in the literature on this issue suggests that vedolizumab has significant efficacy in chronic refractory or antibiotic-dependent pouchitis, also in patients who failed to respond to other treatments including those with anti-TNF agents.