Abstract | OBJECTIVES: METHODS: We conducted a prospective study between January 2014 and April 2016. Patients with antibiotic-refractory pouchitis were treated with IFX. Serum TNF-α levels were measured before IFX induction. Diagnoses were confirmed using the modified Pouchitis Disease Activity Index (m-PDAI). Responders were defined as patients with an m-PDAI score lower than 5. Recurrence was defined as an m-PDAI score exceeding 5 during maintenance treatment or a need for additional treatments. Associations between serum TNF-α level and efficacy of IFX during 52 weeks of maintenance therapy were evaluated. RESULTS: Thirteen patients were eligible for this study. The short-term efficacy was 8/13 (61.5%). Four patients could not be maintained with IFX alone. The cumulative maintenance ratio was 30.8%/52 weeks, and the cut-off value for serum TNF-α was 1.93 pg/mL for short-term response. Although there was no significant association between serum TNF-α and treatment response, IFX treatment was unsuccessful for all five patients with TNF-α levels below 1.93 pg/mL, including four short-term non-responders and one long-term non-responder. CONCLUSION: Serum TNF-α level was not an independent predictor of IFX efficacy for refractory pouchitis. However, IFX may be effective for patients with elevated serum TNF-α. Future studies should assess this possibility.
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Authors | Motoi Uchino, Hiroki Ikeuchi, Toshihiro Bando, Akihiro Hirata, Teruhiro Chohno, Hirofumi Sasaki, Yuki Horio, Shiro Nakamura |
Journal | Journal of the anus, rectum and colon
(J Anus Rectum Colon)
Vol. 1
Issue 4
Pg. 106-111
( 2017)
ISSN: 2432-3853 [Electronic] Japan |
PMID | 31583309
(Publication Type: Journal Article)
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Copyright | Copyright © 2017 by The Japan Society of Coloproctology. |