Continued concomitant antibiotic or immunosuppression therapies reduce the risk of pouchitis among patients with ileal pouch-anal anastomosis and primary sclerosing cholangitis
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Complications such as intermittent pouchitis (IP) and chronic inflammatory disorders of the pouch (CP) are common after ileal pouch-anal anastomosis (IPAA), particularly among patients with both ulcerative colitis and primary sclerosing cholangitis (PSC). There are no standardized approaches for prophylaxis against these complications for patients with PSC undergoing IPAA. We compared outcomes among patients with PSC and IPAA who received antibiotic or immunosuppressive therapies to those who did not. Methods: We designed a retrospective cohort study that included patients with ulcerative colitis and PSC from 7 tertiary care centers that underwent IPAA between 1994 and 2023. Patients were categorized on whether they received medications following IPAA that may provide primary prophylactic benefit, such as antibiotics, probiotics, immunomodulators, or biologic medications; and the proportion of patients developing IP and CP was evaluated. Results: A total of 172 patients were included in the cohort, and 13 (7.6%) patients received antibiotics or immunosuppressant medications. Antibiotics and probiotics were the most common therapy (5 patients, 2.9%), followed by biologics, small-molecule inhibitors, immunomodulators, or mesalamine (all 1 patient, 0.6%). Compared to patients not receiving antibiotics or immunosuppression, patients receiving antibiotics or immunosuppression were significantly less likely to develop IP (69.2% vs 91.2%; P = .03; odds ratio 0.22; 95% CI, 0.06-0.80) and CP (23.1% vs 56.0%, P = 0.04; OR 0.24, 95% CI, 0.06-0.89). Conclusions: In this retrospective cohort of patients with ulcerative colitis and PSC undergoing IPAA, usage of concomitant antibiotics or immunosuppression was low. However, use of concomitant antibiotics or immunosuppression may decrease the burden of inflammatory conditions of the pouch in these high-risk patients.
Source: UNC Libraries
DOI: 10.17615/69sv-6252
Institution: University of North Carolina at Chapel Hill
Topic: Inflammatory Bowel Disease
Subfield: Genetics
Domain: Life Sciences
Open Access status: green
Funders: National Science Foundation, Ankara Universitesi, Fondazione Internazionale Premio Balzan, Israel National Road Safety Authority, Kenneth Rainin Foundation, Wellcome Trust, Rockefeller University, UK Research and Innovation, Universidad Santiago de Cali, European Commission, Department of Science and Technology, Ministry of Science and Technology, India, Deutsche Forschungsgemeinschaft, National Natural Science Foundation of China, ZonMw, Chinese Academy of Sciences, Korea University, Ministry of Science and Technology of the People's Republic of China, China Postdoctoral Science Foundation, Science and Technology Commission of Shanghai Municipality, Ministry of Health, Labour and Welfare, Ministry of Oceans and Fisheries, Ministry of Agriculture, Food and Rural Affairs, Korea Institute for Advancement of Technology, Korea Institute of Science and Technology, Korea Research Institute of Bioscience and Biotechnology, National Research Foundation of Korea, Natural Science Foundation of Hebei Province, Magyar Tudományos Akadémia, Israel Science Foundation, Tehran University of Medical Sciences and Health Services, China Scholarship Council, Natural Science Foundation of Gansu Province, Zhejiang University, Zhejiang Chinese Medical University, Natural Science Foundation of Heilongjiang Province, Natural Science Foundation of Chongqing, Russian Science Foundation, Qassim University, Istanbul Teknik Üniversitesi, Univerza v Ljubljani, Soochow University, Beijing University of Civil Engineering and Architecture, Novo Nordisk Fonden, Politechnika Lódzka, Korea Institute of Marine Science and Technology promotion, Ministry of the Interior and Safety, Saga University, Ministry of Science and ICT, South Korea, National Institutes of Health, Economic and Social Research Council, Human Resource Development Group, Science and Engineering Research Board, Fundação para a Ciência e a Tecnologia, Board of Research in Nuclear Sciences, European Regional Development Fund, Agencia Estatal de Investigación, Korea Institute of Planning and Evaluation for Technology in Food, Agriculture and Forestry, National Institute on Drug Abuse, National Institute of General Medical Sciences, National Institute of Neurological Disorders and Stroke, National Institute of Environmental Health Sciences, National Institute of Arthritis and Musculoskeletal and Skin Diseases, U.S. National Library of Medicine, National Center for Advancing Translational Sciences, Technology Development, Natural Science Foundation of Zhejiang Province, Korea Institute, Consorcio Interuniversitario do Sistema Universitario de Galicia, Research Ireland
OpenAlex ID: W7203923960
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