The Importance of the EARNEST Trial –Vedolizumab for Chronic Pouchitis

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V Jairath et al. Clin Gastroenterol Hepatol 2025; 23: 321-330. Open Access! Mucosal Healing With Vedolizumab in Patients With Chronic Pouchitis: EARNEST, a Randomized, Double-Blind, Placebo-Controlled Trial

Methods: EARNEST, a randomized, double-blind, placebo-controlled study, evaluated vedolizumab efficacy and safety in adults with chronic pouchitis. 

Key findings:

  • More patients treated with vedolizumab vs placebo achieved mucosal healing, reduction in ulcers and ulcerated pouch area and SES-CD remission.
Reduction in the Number of Ulcers was much better for Vedolizumab than Placebo
Proportion of patients with (A) change in ulcerated surface area
and (B) with no ulcers (ulcers >5 mm, erosions ≤5 mm)

My take: Fortunately, chronic pouchitis is uncommon in the pediatric population. This study shows that many patients with chronic pouchitis improve with vedolizumab.

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