{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T19:01:04Z","timestamp":1792004464820,"version":"4.4.0"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T00:00:00Z","timestamp":1753401600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Medically refractory ulcerative colitis may require colectomy with ileal pouch-anal anastomosis. Complications of the J-pouch include pouchitis, occurring in 50%-80% of patients, and Crohn\u2019s disease (CD) of the pouch, occurring in 3%-17%. Our aim was to evaluate the efficacy and safety of ustekinumab (UST) and vedolizumab (VDZ) in patients with CD of the pouch.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a retrospective, multicenter cohort study of adults with CD of the pouch treated with UST or VDZ. The primary outcome was clinical response at 3 or 6 months. Secondary outcomes included clinical remission, endoscopic response, histologic response, pouch failure or surgery, and adverse effects of therapy. Multivariable logistic regression evaluated the efficacy and safety of UST versus VDZ, adjusted for age, smoking status, disease duration, corticosteroid use, and antibiotic use. Kaplan\u2013Meier survival analysis evaluated the durability of UST versus VDZ for CD of the pouch.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>One hundred and four patients were included in this analysis. Seventy-seven patients were treated with UST and 57 patients were treated with VDZ between 2011 and 2021. A total of 64\/77 (83%) UST-treated patients and 45\/57 (79%) VDZ-treated patients had prior biologic exposure. Clinical response occurred in 62% UST-treated patients and 53% VDZ-treated patients at 3 months, and in 56% and 46% at 6 months, respectively. Clinical remission occurred in 32% UST-treated patients and 18% VDZ-treated patients at 3 months and 29% and 21% at 6 months, respectively. Among those treated with UST, 41% achieved endoscopic response, 10% achieved endoscopic remission, 46% achieved histologic response, and 7% achieved histologic remission. Among those treated with VDZ, 27% achieved endoscopic response, 16% achieved endoscopic remission, 26% achieved histologic response, and 8% achieved histologic remission. Over a follow-up period of 3 years, 5% UST-treated patients had inflammatory bowel disease (IBD)-related hospitalization, and 9% required pouch-failure surgery. In total, 3% VDZ-treated patients had IBD-related hospitalization and 5% required pouch-failure surgery. Reported adverse effects were uncommon, including arthralgias (1), hair loss (1), syncope (1), and upper respiratory infection (1) for UST and wrist edema (1) and elevated transaminases (1) for VDZ. In multivariable analyses, patients on UST were more likely to have a clinical response compared to VDZ at 3 months (OR 2.73, 95% [CI] 1.13-6.56, P\u2005=\u2005.025) and 6 months (OR 2.53, 95% CI: 1.01-6.29, P\u2005=\u2005.046). UST had significantly longer durability of treatment than VDZ (log-rank P\u2005&amp;lt;\u2005.005).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In one of the largest cohorts evaluating UST and VDZ for CD of the pouch thus far, these biologics were found to be safe and effective treatments for CD of the pouch.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ibd\/izaf146","type":"journal-article","created":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T07:39:29Z","timestamp":1750750769000},"page":"3142-3148","source":"Crossref","is-referenced-by-count":4,"title":["Efficacy and Safety of Ustekinumab and Vedolizumab for Crohn\u2019s Disease of the Pouch"],"prefix":"10.1093","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-3987-2463","authenticated-orcid":false,"given":"Sunhee","family":"Park","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, University of California , Irvine, Orange, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kian","family":"Keyashian","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Stanford University , Palo Alto, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Santa Clara Valley Medical Center , San Jose, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Limsui","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Stanford University , Palo Alto, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Spencer","family":"Frost","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Stanford University , Palo Alto, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raul","family":"Vazquez","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Stanford University , Palo Alto, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleanor","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University of California , Irvine, Orange, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Ebriani","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University of California Los Angele , Los Angeles, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Maas","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Johns Hopkins University , Baltimore, MD ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9995-7942","authenticated-orcid":false,"given":"Alyssa","family":"Parian","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Johns Hopkins University , Baltimore, MD ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Lazarev","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Johns Hopkins University , Baltimore, MD ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nimisha","family":"Parekh","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University of California , Irvine, Orange, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny S","family":"Sauk","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University of California Los Angele , Los Angeles, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berkeley","family":"Limketkai","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University of California Los Angele , Los Angeles, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,7,25]]},"reference":[{"issue":"9","key":"2025112116472035600_CIT0001","doi-asserted-by":"publisher","first-page":"2001","DOI":"10.1097\/MIB.0b013e318281f3bb","article-title":"Epidemiology and natural history task force of the international organization of the study of inflammatory bowel disease. A review of mortality and surgery in ulcerative colitis: milestones of the seriousness of the disease","volume":"19","author":"Bernstein","year":"2013","journal-title":"Inflamm Bowel Dis."},{"key":"2025112116472035600_CIT0002","first-page":"51","article-title":"Pouchitis: definition, risk factors, frequency, natural history, classification, and public health perspective","volume-title":"Trends in Inflammatory Bowel Disease.","author":"Sandborn","year":"1997"},{"issue":"5","key":"2025112116472035600_CIT0003","first-page":"355","article-title":"Diagnosis and","volume":"4","author":"Shen","year":"2008","journal-title":"Gastroenterol Hepatol."},{"issue":"5","key":"2025112116472035600_CIT0004","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1111\/apt.13905","article-title":"Systematic review with meta-analysis: the management of chronic refractory pouchitis with an evidence-based treatment algorithm","volume":"45","author":"Segal","year":"2017","journal-title":"Aliment Pharmacol Ther."},{"issue":"1","key":"2025112116472035600_CIT0005","doi-asserted-by":"publisher","first-page":"1","DOI":"10.5217\/ir.2020.00047","article-title":"Pouchitis in inflammatory bowel disease: a review of diagnosis, prognosis, and treatment","volume":"19","author":"Akiyama","year":"2021","journal-title":"Intest Res."},{"issue":"8","key":"2025112116472035600_CIT0006","doi-asserted-by":"publisher","first-page":"647","DOI":"10.1097\/MCG.0000000000000367","article-title":"Use of biologics in pouchitis: a systematic review","volume":"49","author":"Herfarth","year":"2015","journal-title":"J Clin Gastroenterol."},{"issue":"5","key":"2025112116472035600_CIT0007","doi-asserted-by":"publisher","first-page":"989","DOI":"10.1093\/ibd\/izy020","article-title":"Management of pouchitis and other common complications of the pouch","volume":"24","author":"Dalal","year":"2018","journal-title":"Inflamm Bowel Dis."},{"issue":"11","key":"2025112116472035600_CIT0008","doi-asserted-by":"publisher","first-page":"1061","DOI":"10.1007\/s10151-014-1197-x","article-title":"Ileal pouch fistulas after restorative proctocolectomy: management and outcomes","volume":"18","author":"Gaertner","year":"2014","journal-title":"Tech Coloproctol."},{"issue":"2","key":"2025112116472035600_CIT0009","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1002\/ibd.21037","article-title":"Efficacy of infliximab in refractory pouchitis and Crohn\u2019s disease-related complications of the pouch: a Belgian case series","volume":"16","author":"Ferrante","year":"2010","journal-title":"Inflamm Bowel Dis."},{"issue":"4","key":"2025112116472035600_CIT0010","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1093\/ecco-jcc\/jjv225","article-title":"Infliximab to treat refractory inflammation after pelvic pouch surgery for ulcerative colitis","volume":"10","author":"Kelly","year":"2016","journal-title":"J Crohns Colitis."},{"issue":"4","key":"2025112116472035600_CIT0011","doi-asserted-by":"publisher","first-page":"767","DOI":"10.1093\/ibd\/izy302","article-title":"Ustekinumab is effective for the treatment of Crohn\u2019s disease of the pouch in a multicenter cohort","volume":"25","author":"Weaver","year":"2019","journal-title":"Inflamm Bowel Dis."},{"issue":"2","key":"2025112116472035600_CIT0012","doi-asserted-by":"publisher","first-page":"429","DOI":"10.1053\/gast.1999.0029900429","article-title":"Successful management of Crohn\u2019s disease of the ileoanal pouch with infliximab","volume":"117","author":"Ricart","year":"1999","journal-title":"Gastroenterology."},{"issue":"5","key":"2025112116472035600_CIT0013","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1111\/j.1365-2036.2008.03920.x","article-title":"Administration of adalimumab in the treatment of Crohn\u2019s disease of the ileal pouch","volume":"29","author":"Shen","year":"2009","journal-title":"Aliment Pharmacol Ther."},{"issue":"1","key":"2025112116472035600_CIT0014","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1007\/DCR.0b013e3181fc9f04","article-title":"Infliximab and\/or azathioprine in the treatment of Crohn\u2019s disease-like complications after IPAA","volume":"54","author":"Haveran","year":"2011","journal-title":"Dis Colon Rectum."},{"issue":"1","key":"2025112116472035600_CIT0015","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1093\/ecco-jcc\/jjw134","article-title":"Outcomes with anti-tumor necrosis factor-alpha therapy and serology in patients with denovo Crohn\u2019s disease after ileal pouch anal anastomosis","volume":"11","author":"Robbins","year":"2017","journal-title":"J Crohns Colitis."},{"issue":"9","key":"2025112116472035600_CIT0016","doi-asserted-by":"publisher","first-page":"1569","DOI":"10.1093\/ibd\/izz030","article-title":"Efficacy of vedolizumab for refractory pouchitis of the ileo-anal pouch: results form a multicenter US cohort","volume":"25","author":"Gregory","year":"2019","journal-title":"Inflamm Bowel Dis."},{"issue":"12","key":"2025112116472035600_CIT0017","doi-asserted-by":"publisher","first-page":"2232","DOI":"10.1002\/ibd.22933","article-title":"Adalimumab therapy in Crohn\u2019s disease of the ileal pouch","volume":"28","author":"Li","year":"2012","journal-title":"Inflamm Bowel Dis."},{"issue":"9","key":"2025112116472035600_CIT0018","doi-asserted-by":"publisher","first-page":"1051","DOI":"10.1080\/00365521.2018.1496271","article-title":"Long term outcomes of initial infliximab therapy for inflammatory pouch pathology: a multi-center retrospective study","volume":"53","author":"Segal","year":"2018","journal-title":"Scand J Gastroenterol."},{"issue":"10","key":"2025112116472035600_CIT0019","doi-asserted-by":"publisher","first-page":"2239","DOI":"10.1111\/j.1572-0241.2003.07675.x","article-title":"Management of Crohn\u2019s disease of the ileoanal pouch with infliximab","volume":"98","author":"Colombel","year":"2003","journal-title":"Am J Gastroenterol."},{"issue":"1","key":"2025112116472035600_CIT0020","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1053\/j.gastro.2023.10.015","article-title":"AGA clinical practice guideline on the management of pouchitis and inflammatory pouch disorders","volume":"166","author":"Barnes","year":"2024","journal-title":"Gastroenterology."}],"container-title":["Inflammatory Bowel Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ibdjournal\/advance-article-pdf\/doi\/10.1093\/ibd\/izaf146\/63843650\/izaf146.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ibdjournal\/article-pdf\/31\/11\/3142\/63843650\/izaf146.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ibdjournal\/article-pdf\/31\/11\/3142\/63843650\/izaf146.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T21:47:27Z","timestamp":1763761647000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ibdjournal\/article\/31\/11\/3142\/8212105"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,25]]},"references-count":20,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,7,25]]},"published-print":{"date-parts":[[2025,11,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ibd\/izaf146","relation":{},"ISSN":["1078-0998","1536-4844"],"issn-type":[{"value":"1078-0998","type":"print"},{"value":"1536-4844","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,11]]},"published":{"date-parts":[[2025,7,25]]}}}