Techniques in Coloproctology

, Volume 22, Issue 3, pp 251–252 | Cite as

Effective use of ustekinumab for prepouch ileitis without improvement of concomitant pouchitis

  • N. Teich
  • A. Stallmach

Dear Sir,

About one half of all patients with ulcerative colitis who have had a restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) experience at least one flare of pouchitis within the first 10 years after surgery. In comparison, very little evidence is available about prepouch ileitis (PI), an acute or chronic inflammation of the afferent limb of the pouch [1]. In a recent original article from Italy, Rottoli et al. [2] report a profound analysis of clinical features, endoscopic characteristics, therapeutic approaches and long-term outcomes of a large cohort of PI patients. One distinctive mark of PI is an insufficient response to single or combined immunosuppression. Although very up to date, the study covers observations from between 1989 and 2016 [2]. Therefore, it does not allow the analysis of success rates of new biologic agents, such as vedolizumab (VDZ) or ustekinumab (UST). In this report, we will add one new piece of evidence which may expand our...


Compliance with ethical standards

Conflict of interest

Niels Teich and Andreas Stallmach received advisory and lecture fees from Janssen.

Ethical approval

The present paper was exempt from approval.

Informed consent

Informed consent was obtained from the individual participant included in the study.


  1. 1.
    Samaan MA, de Jong D, Sahami S et al (2016) Incidence and severity of prepouch ileitis: a distinct disease entity or a manifestation of refractory pouchitis? Inflamm Bowel Dis 22:662–668CrossRefPubMedGoogle Scholar
  2. 2.
    Rottoli M, Vallicelli C, Bigonzi E et al (2018) Prepouch ileitis after ileal pouch-anal anastomosis: patterns of presentation and risk factors for failure of treatment. J Crohn’s Colitis. Google Scholar
  3. 3.
    Zaghiyan K, Kamiński JP, Barmparas G, Fleshner P (2016) De novo Crohn’s disease after Ileal pouch-anal anastomosis for ulcerative colitis and inflammatory bowel disease unclassified: long-term follow-up of a prospective inflammatory bowel disease registry. Am Surg 82:977–981PubMedGoogle Scholar
  4. 4.
    Bär F, Dietrich NA, Krause Tet al; German IBD Study Group (2018) Vedolizumab in the treatment of chronic, antibiotic dependent or refractory Pouchitis. Aliment Pharmacol Ther.
  5. 5.
    Tran-Minh ML, Allez M, Gornet JM (2017) Successful treatment with ustekinumab for chronic refractory pouchitis. J Crohn’s Colitis 11:1156CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Joint Internal Medicine Practice for Digestive and Metabolic DiseasesLeipzig and SchkeuditzLeipzigGermany
  2. 2.Internal Medicine Clinic IVUniversity ClinicJenaGermany
  3. 3.Faculty of MedicineFriedrich-Schiller UniversityJenaGermany

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