BACKGROUND Chronic antibiotic-refractory pouchitis (CARP) occurs in up to 15% of patients with ulcerative colitis (UC) following proctocolectomy with ileal pouch-anal anastomosis (IPAA). AIM To investigate the effectiveness of ustekinumab in the treatment of CARP. METHODS This was a retrospective single-center study of UC patients with an IPAA, who subsequently developed CARP and received ustekinumab with standard Crohn's disease (CD) dosing between 2016 and 2018. Patients with CD of the pouch were excluded. Demographic, clinical, and endoscopic data were collected. Outcomes included a change in the endoscopic subscore of the Pouchitis Disease Activity Index (PDAI), change in the ulcerated surface area, clinical response, and the number of bowel movements per 24 h. RESULTS Twenty-four patients with CARP were included for analysis. Median follow-up time was 12.9 months (IQR 7.9-16). Twelve patients (50%) had a clinical response with the median number of bowel movements within 24 h decreasing from 8 (IQR, 5-12) to 6 (IQR, 5-8) P = 0.002. Thirteen patients had pouchoscopies available post-ustekinumab treatment. In these patients, the median endoscopic subscore of the PDAI decreased from 5 (IQR, 3-6) to 4 (IQR, 2-5), P = 0.016. Likewise, among these thirteen patients, nine (69%) had an ulcerated surface area > 10% before ustekinumab treatment; after treatment with ustekinumab, only four patients (31%) still had an ulcerated surface area of > 10%. CONCLUSIONS This is the largest study of ustekinumab treatment for patients with chronic antibiotic-refractory pouchitis. We found that ustekinumab therapy led to the improvement in clinical and endoscopic endpoints.

中文翻译：

---

Ustekinumab 对治疗慢性抗生素难治性储袋炎有效。

背景 慢性抗生素难治性储袋炎 (CARP) 发生在高达 15% 的溃疡性结肠炎 (UC) 患者中，其中包括直肠切除术和回肠储袋肛管吻合术 (IPAA)。目的探讨优特克单抗治疗CARP的疗效。方法 这是一项回顾性单中心研究，对 2016 年至 2018 年间患有 IPAA 的 UC 患者进行了回顾性单中心研究，这些患者随后出现了 CARP 并接受了标准克罗恩病 (CD) 剂量的优特克单抗治疗。排除了囊袋 CD 患者。收集了人口统计学、临床和内窥镜数据。结果包括袋炎疾病活动指数 (PDAI) 的内窥镜子评分的变化、溃疡表面积的变化、临床反应和每 24 小时排便次数。结果 24 名 CARP 患者被纳入分析。中位随访时间为 12.9 个月（IQR 7.9-16）。12 名患者 (50%) 有临床反应，24 小时内排便次数中位数从 8 (IQR, 5-12) 减少到 6 (IQR, 5-8) P = 0.002。13 名患者在优特克单抗治疗后可进行袋镜检查。在这些患者中，PDAI 的内窥镜评分中位数从 5 (IQR, 3-6) 降至 4 (IQR, 2-5)，P = 0.016。同样，在这 13 名患者中，9 名 (69%) 在优特克单抗治疗前溃疡表面积 > 10%；用优特克单抗治疗后，只有 4 名患者 (31%) 的溃疡表面积仍大于 10%。结论 这是最大的优特克单抗治疗慢性抗生素难治性储袋炎患者的研究。我们发现优特克单抗治疗导致临床和内窥镜终点的改善。