title: Oral beclomethasone dipropionate in chronic refractory pouchitis.
abstract: BACKGROUND
  Pouchitis is the major long-term complication after ileal-pouch anal-anastomosis for ulcerative colitis. Ten to 15% of patients develop chronic pouchitis, either treatment responsive or treatment refractory.
  
  
  OBJECTIVE
  To evaluate the efficacy of oral beclomethasone dipropionate in inducing remission and improving quality of life in patients with chronic refractory pouchitis.
  
  
  METHODS
  Ten consecutive patients with active pouchitis, not responding to 1-month antibiotic treatment, were treated with beclomethasone dipropionate 10 mg⁄day for 8 weeks. Clinical, endoscopic and histological evaluations were undertaken before and after treatment, according to the Pouchitis Disease Activity Index (PDAI). Remission was defined as a combination of PDAI clinical score of ≤2, endoscopic score of ≤1 and a total PDAI score of ≤4. The quality of life was assessed with the Inflammatory Bowel Disease Questionnaire (IBDQ).
  
  
  RESULTS
  Eight of 10 patients (80%) achieved remission. The median total PDAI scores before and after therapy were, respectively, 12 (range 8-14) and 3 (range 2-9) (P<0.001). The median IBDQ score also significantly improved from 120 (range 77-175) to 175 (range 85-220) (p<0.001).
  
  
  CONCLUSIONS
  Eight-week treatment with oral beclomethasone dipropionate appears effective in inducing remission in patients with active pouchitis refractory to antibiotic treatment.
authors.affiliation: IBD Unit, DIMEC, University of Bologna, Italy. Electronic address: paolo.gionchetti@unibo.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Gionchetti
authors.affiliation: IBD Unit, DIMEC, University of Bologna, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Calabrese
authors.affiliation: IBD Unit, DIMEC, University of Bologna, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Calafiore
authors.affiliation: IBD Unit, DIMEC, University of Bologna, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Praticò
authors.affiliation: IBD Unit, DIMEC, University of Bologna, Italy.
authors.forename: Gilberto
authors.initials: G
authors.lastname: Poggioli
authors.affiliation: IBD Unit, DIMEC, University of Bologna, Italy.
authors.forename: Silvio
authors.initials: S
authors.lastname: Laureti
authors.affiliation: IBD Unit, DIMEC, University of Bologna, Italy.
authors.forename: Nunzia
authors.initials: N
authors.lastname: Capozzi
authors.affiliation: IBD Unit, DIMEC, University of Bologna, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Campieri
authors.affiliation: IBD Unit, DIMEC, University of Bologna, Italy.
authors.forename: Fernando
authors.initials: F
authors.lastname: Rizzello
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001507:Beclomethasone / Q000008:administration & dosage / Q000627:therapeutic use*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D019449:Pouchitis / Q000188:drug therapy*; D011788:Quality of Life; D012074:Remission Induction; D012720:Severity of Illness Index
chemical_list: D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D001507:Beclomethasone
keywords: Chronic refractory pouchitis; IBDQ; Oral beclomethasone dipropionate; PDAI