Disease and Treatment Patterns Among Patients With Pouch-related Conditions in a Cohort of Large Tertiary Care Inflammatory Bowel Disease Centers in the United States

Edward L Barnes; Laura Raffals; Millie D Long; Gaurav Syal; Maia Kayal; Ashwin Ananthakrishnan; Benjamin Cohen; Joel Pekow; Parakkal Deepak; Jean-Frederic Colombel; Hans H Herfarth; Robert S Sandler

doi:10.1093/crocol/otaa039

Disease and Treatment Patterns Among Patients With Pouch-related Conditions in a Cohort of Large Tertiary Care Inflammatory Bowel Disease Centers in the United States

Crohns Colitis 360. 2020 Jul;2(3):otaa039. doi: 10.1093/crocol/otaa039. Epub 2020 Jul 24.

Authors

Edward L Barnes^{1

2

3}, Laura Raffals⁴, Millie D Long^{1

2

3}, Gaurav Syal⁵, Maia Kayal⁶, Ashwin Ananthakrishnan⁷, Benjamin Cohen⁶, Joel Pekow⁸, Parakkal Deepak⁹, Jean-Frederic Colombel⁶, Hans H Herfarth^{1

2

3}, Robert S Sandler^{1

2}

Affiliations

¹ Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA.
² Center for Gastrointestinal Biology and Disease, University of North Carolina, Chapel Hill, North Carolina, USA.
³ Multidisciplinary Inflammatory Bowel Diseases Center, University of North Carolina, Chapel Hill, North Carolina, USA.
⁴ Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
⁵ Inflammatory Bowel Disease Center, Cedars-Sinai Medical Center, Los Angeles, California, USA.
⁶ The Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
⁷ Division of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts, USA.
⁸ Section of Gastroenterology, Hepatology, and Nutrition, University of Chicago, Chicago, Illinois, USA.
⁹ Washington University Inflammatory Bowel Diseases Center, St. Louis, Missouri, USA.

Abstract

Background: Gaps exist in our understanding of the clinical course of pouch-related disorders.

Methods: We evaluated baseline disease activity and longitudinal treatment patterns among patients with inflammatory conditions of the pouch.

Results: Among 468 patients with an ileal pouch-anal anastomosis (IPAA), 94 (20%) had acute pouchitis, 96 (21%) had chronic pouchitis, and 192 (41%) had Crohn disease of the pouch. Following an IPAA, 38% of patients were treated with a biologic and 11% underwent inflammatory bowel disease- or bowel-related surgery.

Conclusions: Treatment patterns after IPAA indicate that pouch-related disorders have a significant impact on individual patients and the healthcare system.

Keywords: biologic therapy; ileal pouch-anal anastomosis; pouchitis.

Grants and funding

P30 DK034987/DK/NIDDK NIH HHS/United States