Biological therapies for inflammatory pouch disorders: insights and outcomes from the RESERVO study of GETECCU
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Inflammatory pouch disorders can be refractory to conventional therapy. Evidence on biological therapy from large cohorts is scarce. Objective: To explore the use and effectiveness of biological therapy for inflammatory pouch disorders. Design: A retrospective and multicentre study. Methods: We included patients diagnosed with pouchitis, Crohn’s Disease of the Pouch (CDP) or cuffitis and treated with biological therapy. Effectiveness was evaluated at 12 months based on normalisation of stool frequency, absence of pain, faecal urgency or fistula discharge (clinical remission), or as any improvement in these symptoms (clinical response). We also compared the effectiveness of a second biologic after anti-tumour necrosis factor (anti-TNF) failure using descriptive and comparative statistics. Results: In total, 145 patients were included; 62% were men and the median age was 54 (20–71) years. Overall, 212 lines of treatment were evaluated (95 infliximab, 69 adalimumab, 7 golimumab, 35 vedolizumab and 26 ustekinumab). At least a second line of treatment was received by 41% of patients. Overall, 66% had chronic pouchitis and 29% had CDP. Clinical remission rates at 12 months were 45%, 44%, 43%, 39% and 45% for infliximab, adalimumab, golimumab, vedolizumab and ustekinumab, respectively. No differences were found based on the type of disease. Vedolizumab was the only treatment to show better results as a first-line therapy (50% vs 33%, p < 0.05). Thirty-nine patients received a second therapy after anti-TNF failure. Second anti-TNF use had higher risks of failure (odds ratio (OR) 4.8, 95% confidence interval (CI) 2.3–19) and discontinuation (OR 5.52, 95% CI 1.94–25.5). Conclusion: Biological therapy is a cornerstone in the treatment of pouch disorders, demonstrating consistently high effectiveness. After anti-TNF failure, another mechanism of action should be employed.
Authors: Francisco Mesonero, Yamile Zabana, Agnès Fernández-Clotet, Eduardo Leo-Carnerero, Berta Caballol, Andrea Núñez, María José García, Federico Bertoletti, Guillermo Bastida, Gerard Suris, Begoña Casis, Rocío Ferreiro-Iglesias, Margalida Calafat, Itxaso Jiménez, José Miranda-Bautista, Luis Javier Lamuela, Ingrid Fajardo, Leyanira Torrealba, Rodrigo Nájera, Rosa María Sáiz-Chumillas, Irene González-Partida, Miren Vicuña, Natalia García-Morales, Ana Gutiérrez, Alicia López-García, José Manuel Benítez, Cristina Rubín de Célix, Coral Tejido, Eduard Brunet-Mas, Alejandro Hernandez-Camba, Cristina Suarez Ferrer, Iago Rodríguez-Lago, Marta Piqueras, Andrés Castaño, Laura Ramos, Ana Sobrino, María Carmen Rodríguez-Grau, Alfonso Elosua, Miguel A. Montoro-Huguet, Ruth Baltar, José María Huguet, Benito Hermida, Antonio Caballero-Mateos, Luis Sánchez-Guillén, Abdel Bouhmidi, Ramón Pajares, Iria Baston-Rey, Antonio López-Sanromán, Agustín Albillos, Manuel Barreiro-de Acosta
Institutions: Hospital Universitario Ramón y Cajal, University Hospital Mútua de Terrassa, Mútua Terrassa, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Hospital Clínic de Barcelona, Consorci Institut D'Investigacions Biomediques August Pi I Sunyer, Fundació de Recerca Clínic Barcelona-Institut d’Investigacions Biomèdiques August Pi i Sunyer, Hospital Universitario Virgen del Rocío, Marqués de Valdecilla University Hospital, Instituto de Investigación Marqués de Valdecilla, Hospital de Sant Pau, Hospital Universitari i Politècnic La Fe, Bellvitge University Hospital, Hospital Universitario 12 De Octubre, Complejo Hospitalario Universitario de Santiago, Hospital Universitari Germans Trias i Pujol, BioCruces Health research Institute, Hospital de Galdakao, Hospital General Universitario Gregorio Marañón, Hospital Universitario Miguel Servet, Hospital Universitari de Girona Doctor Josep Trueta, Hospital Universitario Río Hortega, Hospital Universitario de Burgos, Hospital Universitario Puerta de Hierro Majadahonda, Complejo Hospitalario de Navarra, University Hospital Complex Of Vigo, Hospital General Universitario de Alicante Doctor Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Hospital Del Mar, Hospital del Mar Research Institute, Hospital Universitario Reina Sofía, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, Complejo Hospitalario de Ourense, Corporació Sanitària Parc Taulí, Hospital Universitario Nuestra Señora de Candelaria, Hospital Universitario La Paz, Hospital La Paz Institute for Health Research, Consorci Sanitari de Terrassa, Hospital Universitario Central de Asturias, Hospital Universitario de Canarias, Hospital General Universitario de Ciudad Real, Hospital Universitario del Henares, Hospital General San Jorge, Hospital General Universitario De Valencia, Hospital Universitario De Cabueñes, Hospital General Universitario de Elche, Hospital Universitario Infanta Sofía, Universidad de Alcalá
Language: English
Topic: Inflammatory Bowel Disease
Subfield: Genetics
Domain: Life Sciences
Open Access status: gold
Estimated APC paid: $2,700
OpenAlex ID: W7130502172