Oral vancomycin is associated with less therapy intensification in adults with symptomatic inflammatory bowel disease and underlying primary sclerosing cholangitis
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background: Case reports describe the use of oral vancomycin therapy (OVT) in adult patients with concomitant symptomatic inflammatory bowel disease (IBD) and primary sclerosing cholangitis (PSC). OVT is associated with a higher likelihood of IBD remission in pediatric IBD-PSC patients. However, there are limited data on the association between OVT and IBD disease course in adult IBD-PSC patients. Methods: We retrospectively evaluated IBD therapy intensification in adults with IBD-PSC prescribed OVT at 2 centers. Subjects were stratified by time "on" and "off" OVT. Only those who spent a minimum of 12 months in each period were included. The primary outcome was the frequency of IBD therapy intensification events. Results: Of 31 patients initially considered, 22 met the inclusion criteria. Most patients (68.2%) had fewer or no intensification events while "on OVT" compared to those "off OVT". OVT was associated with fewer therapy intensification events (1.7 vs. 6.7, P=0.021) and steroid prescriptions (0.6 vs. 3.2, P=0.013) per 10 person-years. Conclusions: OVT use is associated with less need for IBD therapy intensification in symptomatic IBD-PSC adult patients. Prospective trials of OVT in such patients are warranted.
Source: Annals of Gastroenterology
Author: Chiraag Kulkarni
Institutions: Stanford Medicine, Stanford University
Language: English
Topic: Inflammatory Bowel Disease
Subfield: Genetics
Domain: Life Sciences
Open Access status: diamond
OpenAlex ID: W4412477995