A case of refractory chronic pouchitis successfully treated with tofacitinib.

Clinical Journal of Gastroenterology
Soh OkanoMasakazu Takazoe

Abstract

We describe a case of refractory pouchitis successfully treated with tofacitinib. The patient was a 20-year-old woman diagnosed with ulcerative colitis at the age of 14 years. She underwent surgery at the age of 18 years for chronic active inflammation, despite an optimal medication regimen. Ten months after surgery, she was diagnosed with pouchitis. She did not respond to conventional conservative treatment; thus, the case was considered as that of refractory chronic pouchitis. Anti-tumor necrosis factor-α (TNF-α) therapy was administered, which led to some improvement; however, pouchitis recurred. Systemic steroid and vedolizumab were also administered, but the response was unsatisfactory. Therefore, surgery was considered; however, the patient refused to undergo surgery. As identical therapies are recommended for ulcerative colitis and pouchitis, they are considered to have a common etiology. Therefore, we considered tofacitinib therapy in this case. After obtaining the patient's informed consent, tofacitinib treatment was initiated. The therapy led to improvement in her symptoms as well as in the appearance of the pouch when observed on endoscopy, and surgery was avoided. Thus, tofacitinib may be considered a therapy option...Continue Reading

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Citations

Aug 3, 2020·The American Journal of Gastroenterology·Christina M BauerHans H Herfarth
Jul 13, 2021·Therapeutic Advances in Gastroenterology·Wendy Rabbenou, Shannon Chang
Jun 25, 2021·Clinical and Experimental Gastroenterology·An Outtier, Marc Ferrante

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