Biological therapies for inflammatory pouch disorders: insights and outcomes from the RESERVO study of GETECCU
Por:
Mesonero, F, Zabana, Y, Fernández-Clotet, A, Leo-Carnerero, E, Caballol, B, Núñez, A, García, MJ, Bertoletti, F, Bastida, G, Suris, G, Casis, B, Ferreiro-Iglesias, R, Calafat, M, Jiménez, I, Miranda-Bautista, J, Lamuela, LJ, Fajardo, I, Torrealba, L, Nájera, R, Sáiz-Chumillas, RM, González-Partida, I, Vicuña, M, García-Morales, N, Gutiérrez, A, López-García, A, Benítez, JM, de Célix, CR, Tejido, C, Brunet-Mas, E, Hernandez-Camba, A, Ferrer, CS, Rodríguez-Lago, I, Piqueras, M, Castaño, A, Ramos, L, Sobrino, A, Rodríguez-Grau, MC, Elosua, A, Montoro-Huguet, MA, Baltar, R, Huguet, JM, Hermida, B, Caballero-Mateos, A, Sánchez-Guillén, L, Bouhmidi, A, Pajares, R, Baston-Rey, I, López-Sanromán, A, Albillos, A, Acosta, MBD
Publicada:
1 feb 2026
Resumen:
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.
Filiaciones:
Mesonero, F:
Hosp Univ Ramon y Cajal, Dept Gastroenterol & Hepatol, Inflammatory Bowel Dis Unit, Cra Colmenar,Km 9-1, Madrid 28034, Spain
Univ Alcala Henares, Madrid, Spain
Zabana, Y:
Hosp Univ Mutua Terrassa, Terrassa, Spain
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Barcelona, Spain
Fernández-Clotet, A:
Hosp Clin Barcelona, Inst Invest Biomed August Pi & Sunyer, Barcelona, Spain
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Murcia, Spain
Leo-Carnerero, E:
Hosp Univ Virgen Rocio, Seville, Spain
Caballol, B:
Hosp Clin Barcelona, Inst Invest Biomed August Pi & Sunyer, Barcelona, Spain
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Murcia, Spain
Núñez, A:
Hosp Univ Virgen Rocio, Seville, Spain
García, MJ:
Hosp Univ Marques Valdecilla, Dept Gastroenterol & Hepatol, Grp Invest Clin & Traslac Enfermedades Digest IDIV, Santander, Spain
Bertoletti, F:
Hosp Santa Creu i St Pau, Barcelona, Spain
Bastida, G:
Hosp Univ & Politecn La Fe, Valencia, Spain
Suris, G:
Hosp Univ Bellvitge, Lhospitalet De Llobregat, Spain
Casis, B:
Hosp Univ 12 Octubre, Madrid, Spain
Ferreiro-Iglesias, R:
Hosp Clin Univ Santiago, Santiago De Compostela, Spain
Calafat, M:
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Barcelona, Spain
Hosp Univ Germans Trias i Pujol, Badalona, Spain
Jiménez, I:
Hosp Galdakao, Biocruces Bizkaia Hlth Res Inst, Gastroenterol, Galdakao, Spain
Miranda-Bautista, J:
Hosp Univ Gregorio Maranon, Madrid, Spain
Lamuela, LJ:
Hosp Univ Miguel Servet, Zaragoza, Spain
Fajardo, I:
Hosp Univ Mutua Terrassa, Terrassa, Spain
Torrealba, L:
Hosp Univ Doctor Josep Trueta, Girona, Spain
Nájera, R:
Hosp Univ Rio Hortega, Valladolid, Spain
Sáiz-Chumillas, RM:
Hosp Univ Burgos, Burgos, Spain
González-Partida, I:
Hosp Univ Puerta Hierro, Madrid, Spain
Vicuña, M:
Complejo Hosp Navarra, Navarra, Spain
García-Morales, N:
Hosp Alvaro Cunqueiro, Vigo, Spain
Gutiérrez, A:
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Barcelona, Spain
Hosp Gen Univ Alicante Doctor Balmis, Inst Invest Sanitaria & Biomed Alicante, Alicante, Spain
López-García, A:
Inst Hosp Mar Invest Med, URFOA, RETICEF, Barcelona, Spain
Benítez, JM:
Hosp Univ Reina Sofia, Cordoba, Spain
de Célix, CR:
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Barcelona, Spain
Univ Autonoma Madrid, Hosp Univ La Princesa, Inst Invest Sanitaria Princesa IIS Princesa, Madrid, Spain
Tejido, C:
Complejo Hosp Univ Ourense, Orense, Spain
Brunet-Mas, E:
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Barcelona, Spain
Hosp Universitari Parc Tauli, Serv Aparell Digestiu, Sabadell, Spain
Hernandez-Camba, A:
Hosp Univ Nuestra Senora Candelaria, Santa Cruz De Tenerife, Spain
Ferrer, CS:
Hosp Univ La Paz, Inst Invest Sanitaria Hosp Univ La Paz IdiPAZ, Serv Cardiol, Madrid, Spain
Rodríguez-Lago, I:
Hosp Galdakao, Biocruces Bizkaia Hlth Res Inst, Gastroenterol, Galdakao, Spain
Piqueras, M:
Consorci Sanit Terrassa, Terrassa, Spain
Castaño, A:
Hosp Univ Cent Asturias, Oviedo, Spain
Ramos, L:
Hosp Univ Canarias, Tenerife, Spain
Sobrino, A:
Univ Gen Hosp Ciudad Real, Ciudad Real, Spain
Rodríguez-Grau, MC:
Hosp Univ Henares, Coslada, Spain
Elosua, A:
Hosp Garcia Orcoyen, Navarra, Spain
Montoro-Huguet, MA:
Hosp Gen Univ San Jorge, Serv Anestesiol & Reanimac, Huesca, Spain
Baltar, R:
Hosp Univ Alava, Serv Nefrol, Vitoria, Alava, Spain
Huguet, JM:
Hosp Gen Univ Valencia, Valencia, Spain
Hermida, B:
Hosp Univ Cabuenes, Gijon, Spain
Caballero-Mateos, A:
Hosp Santa Ana Motril, Granada, Spain
Sánchez-Guillén, L:
Hosp Gen Univ Elche, Secc Neumol, Alicante, Spain
Bouhmidi, A:
Hosp Santa Barbara, Puertollano, Spain
Pajares, R:
Hosp Univ Infanta Sofia, Madrid, Spain
Baston-Rey, I:
Hosp Clin Univ Santiago, Santiago De Compostela, Spain
López-Sanromán, A:
Hosp Univ Ramon y Cajal, Madrid, Spain
Albillos, A:
Hosp Univ Ramon y Cajal, Madrid, Spain
Acosta, MBD:
Hosp Clin Univ Santiago, Santiago De Compostela, Spain
Green Submitted, gold
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