Edward Barnes, MD, on Advances in Pouchitis

Dr Barnes, from the University of North Carolina at Chapel Hill, reviews his presentation from the AIBD regional meeting April 27 on recent research and advances in the treatment of inflammatory diseases of the J-pouch.

Edward Barnes, MD, is an assistant professor of medicine and associate director of the Gastroenterology and Hepatology Fellowship Program at the University of North Carolina School of Medicine at Chapel Hill, North Carolina.

Hi, I'm Ed Barnes from the University of North Carolina at Chapel Hill and it's really a pleasure to be coming to you from the AIBD Regionals where I had the opportunity to speak about the topic of pouchitis, certainly a topic that's near and dear to my heart. I was excited to speak at AIBD Regionals about pouchitis because this is a really exciting time for the field of pouchitis. We've seen a lot of advancement in the last year or so regarding some landmark studies as well as some landmark publications within the realm of pouchitis and that's what I reviewed today.

We started out sort of with a framework of pouchitis that are really based upon the recently published guidelines from the American Gastroenterological Association or the AGA and we try to think about sort of pragmatic definitions for inflammatory conditions of the pouch and how those can frame both clinical care, but importantly, sort of our research priorities as we move into this next realm of standardized care and speaking the same language when we think about taking care of patients with pouches.

We also thought about some of these landmark studies as I mentioned before, the most notable of which was the earnest study and we reviewed data regarding the use of vedolizumab and patients with chronic pouchitis. And I think this is a landmark study because not only did it show that vedolizumab is effective in the treatment of chronic pouchitis, but it really gave us the most robust evidence that we have when we think about treating chronic pouchitis, but a framework for future studies when we think about things like endoscopic healing and how we should think about using other therapies and evaluating other therapies in a prospective manner.

And that should be our research priorities when we think about treating patients and evaluating other therapies, the effectiveness of therapies moving forward for the chronic inflammatory conditions of the pouch. We wrapped up our discussion by thinking about where we can go in the future and what are the unmet needs among patients with inflammatory conditions of the pouch, particularly given the potential rise in the burden among patients with pouchitis, how we might prevent those inflammatory conditions of the pouch, especially in the early stages after a patient has surgery, think about things like primary and secondary prevention and where sort of the evidence falls out based on those AGA guidelines. So it was a really robust discussion. I was really happy to be able to participate in this AIBD regionals, and I hope that you'll find this discussion helpful.

Thanks so much for your interest.