Abstract | BACKGROUND:
Pouchitis is the major long-term complication after ileal-pouch nal anastomosis for ulcerative colitis. Ten to 15% of patients develop a chronic pouchitis, either treatment responsive or treatment refractory. AIM: To evaluate the efficacy of oral budesonide in inducing remission and improving quality of life in patients with chronic refractory pouchitis. METHODS: Twenty consecutive patients with active pouchitis, not responding after 1 month of antibiotic treatment were treated with budesonide controlled ileal release 9 mg/day for 8 weeks. Symptomatic, endoscopic and histological evaluations were undertaken before and after treatment according to Pouchitis Disease Activity Index. Remission was defined as a combination of Pouchitis Disease Activity Index clinical score of < or = 2, endoscopic score of < or = 1 and total Pouchitis Disease Activity Index score of < or = 4. The quality of life was assessed with the Inflammatory Bowel Disease Questionnaire. RESULTS: Fifteen of 20 patients (75%) achieved remission. The median total Pouchitis Disease Activity Index scores before and after therapy were, respectively, 14 (range 9-16) and 3 (range 2-10) (P < 0.001). The median Inflammatory Bowel Disease Questionnaire score also significantly improved from 105 (range 77-175) to 180 (range 85-220) (P < 0.001). CONCLUSION: Eight-week treatment with oral budesonide appears effective in inducing remission in patients with active pouchitis refractory to antibiotic treatment in this open-label study.
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Authors | P Gionchetti, F Rizzello, G Poggioli, F Pierangeli, S Laureti, C Morselli, R Tambasco, C Calabrese, M Campieri |
Journal | Alimentary pharmacology & therapeutics
(Aliment Pharmacol Ther)
Vol. 25
Issue 10
Pg. 1231-6
(May 15 2007)
ISSN: 0269-2813 [Print] England |
PMID | 17451569
(Publication Type: Clinical Trial, Journal Article)
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Chemical References |
- Anti-Bacterial Agents
- Anti-Infective Agents
- Delayed-Action Preparations
- Budesonide
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Topics |
- Administration, Oral
- Adult
- Anti-Bacterial Agents
(therapeutic use)
- Anti-Infective Agents
(administration & dosage)
- Budesonide
(administration & dosage)
- Chronic Disease
- Colitis, Ulcerative
(surgery)
- Delayed-Action Preparations
- Female
- Humans
- Male
- Middle Aged
- Patient Compliance
- Pouchitis
(drug therapy)
- Quality of Life
(psychology)
- Treatment Outcome
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