Pilot study: the use of sulfasalazine for the treatment of acute pouchitis
A Belluzzi, M Serrani, G Roda, M L Bianchi, L Castellani, M Grazia, G Rosati, G Ugolini, E Roda, A Belluzzi, M Serrani, G Roda, M L Bianchi, L Castellani, M Grazia, G Rosati, G Ugolini, E Roda
Abstract
Background: Acute pouchitis, an idiopathic inflammatory condition of the ileal pouch anal anastomosis, is the most frequent complication after proctocolectomy for ulcerative colitis.
Aim: To test the hypothesis that sulfasalazine (SASP) might have a synergistic beneficial effect in acute pouchitis, by combining the anti-inflammatory activity of 5-aminosalicylic Acid and the bacteriostatic effect of sulphapyridine.
Methods: Twenty two patients were investigated for acute pouchitis; the Pouchitis Disease Activity Index (PDAI) was calculated and 11 patients with acute pouchitis (PDAI >7) were included in an open study, after obtaining their informed consent. Patients were treated with SASP 500 mg tablets, two tablets three times per day (3000 mg daily), for 2 months. Pouch endoscopy with biopsies was performed at the entry and at the end of the study.
Results: According to the PDAI score, 8/11 patients (73%) improved their clinical condition and 7/11 (63%) were in remission at the end of the treatment. At 8 weeks, the median PDAI index decreased from 11.2 +/- 2.3 to 6.6 +/- 4.7 P < 0.01. No adverse events or toxicity were reported and all patients completed the study.
Conclusions: Despite the limitations of the current study, sulfasalazine seems to be a potential treatment for acute pouchitis.
Source: PubMed