#DCRJournalClub Recap | Dr. Shen on how does pouchitis in K pouches differ from that in J pouches?

Pouch disorders are challenging to manage:

- antibiotics still the mainstay rx for acute/chronic pouchitis
- budesonide or topical steroids
- anti-TNF, vedolizumab for chronic antibiotic-refractory pouchitis or Crohn's-like disease of the pouch

doi: 10.1038/s41575-024-00920-5

Fecal microbiota transplantation is no better than placebo for chronic pouchitis, and had ⬆️ adverse events.

#MedTwitter #GITwitter #IBD #FMT #microbiome

academic.oup.com/ecco-jcc/advan…

#IBD Horizons24 #BrianFeagan

Research in #IBD :
VDZ works well for pouchitis
UPA for #UlcerativeColitis
Risa for #Crohns
Combo is the way to go, no monotherapy for UC
IL23’s likely more effective than the others

J-pouch anatomy:
- appreciating the anatomy & accurate endoscopic reporting is critical in understanding the aetiology of 'pouchitis'
- different segmental involvement suggest different causes --> different rx approaches

Vedolizumab for chronic pouchitis (EARNEST)

- higher rates of mPDAI remission (≤4) scores at weeks 14 &34
- adapted SES-CD–defined remission increased from 2% --> 21% --> 23%; in contrast, the change in the placebo group was minimal (8%, 6%, and 10%)

(mPDAI is PDAI w/o histo)

#EBMED discusses #Pouchitis

🌟 Preserve the pouch: Stick with therapy,⛔ drug holiday! 💊

🚫 recycling biologics used before colectomy.

🤝 Understand patients goals: talk openly and work together! 🎯

#GITwitter #IBDTwitter

Such a nice time in Stockholm at #ECCO2024 🎉 - presented our findings on cuffitis' association with pouchitis/ileitis, listened to great presentations of cutting-edge research, and explored the city as much as possible. Definitely want to come back one day

Y-ECCO #IBD

Great 💯 presentation by Maia Kayal MD on management of acute and chronic Pouchitis in IBD

American Gastroenterological Association (AGA) Evidence-Based GI: An ACG Publication (EBGI) IBD Horizons Icahn School of Medicine at Mount Sinai
#GITwitter

Pouchitis 50% pac a 10 años desde reservorio
FR: no 🚬 /CEP/ CU extensa Aguda <4sem : Atb
Crónica >4 sem : formulación simoneo (probiótico ) y evitar recurrencia
Refractaria atb 4 sem / budesonida /vedo >efectividad Earnest STUdy . Gran charla Manuel Barreiro GADECCU

A great talk by Maia Kayal MD on #Pouchitis at #EBMed

👛 Most common IPAA cx
🗓️ Time matters - acute vs chronic
💊 Rx antimicrobial, biologics?
🏆 Set goals with pts

❓We don’t know why this occurs!
🔬More research is urgently needed to help discern pathophysiology & help pts

Incredible insights from Bo Shen's presentation on pouchitis at the IG IBD Congress, Italian Congress in IBD. As Director of the IBD Center at Columbia, he expertly delved into both mechanisms and therapies, deepening our understanding of this complex condition! 💊❤️ #Pouchitis

EFFICACY AND SAFETY OF USTEKINUMAB FOR CHRONIC POUCHITIS: A PROSPECTIVE OPEN-LABEL MULTICENTER STUDY - Clinical Gastroenterology and Hepatology cghjournal.org/article/S1542-…

📷Faculty Retroflexions📷

🚨High yield! Dr. David Eskreis gives us insight regarding the AGA Guidelines on the Management of Pouchitis and Inflammatory Pouch Disorders. Please see our fellow’s (Andres Rodriguez, DO, MBA) associated visual abstract!
#FacultyRetroflexions #EmoroidDigest

#EbMed Maia Kayal MD decodes #Pouchitis lingo

🔺Acute/chronic/refractory/Crohns like👇🏽
🔺Therapy algo👇🏽

🔺Vedo: 1st drug shown to be effective in pouchitis in a RCT #ERNEST
🔺UST mostly edfecitve at q4wks dosing
🔺Avoid agents not effective prior to ✂️

Non-pooled multi-donor #FMT was comparable to placebo in inducing clinical remission in patients with chronic #pouchitis , but it was associated with an increase in adverse events Kousgaard et al. Crohn's & Colitis Foundation
academic.oup.com/ecco-jcc/advan…

OUR LATEST ARTICLE HAS BEEN PUBLISHED 🎉

Read our study ‘Antibiotic Use in the 12 months Prior to Ileal Pouch-Anal Anastomosis Increases the Risk for Pouchitis’ here ➡️ pubmed.ncbi.nlm.nih.gov/38556033/

Edward Barnes MD MPH Karachalia Sandri Anastasia #HansHerfarth Tine Jess Danmarks Grundforskningsfond Aalborg Universitet

#WhatsNewOnFMT
#Chronicpouchitis

Analysis of the luminal and mucosal microbiome following FMT in patients with chronic pouchitis:
✔️revealed complex microbiome dynamics
✔️Impact of antiobiotic type as a co-factor
✔️substantial microbial variation
✔️High dissemilarity to the

Got a chance to attend this interactive session Crohn's & Colitis Foundation. Kudos to my senior GI fellow Sotirios G Doukas, MD CPHQ PhD(c) for his presentation on Novel therapies in IBD and Management of Pouchitis.
#GItwitter #IBD