Literature DB >> 24996483

Subcutaneous ustekinumab for the treatment of anti-TNF resistant Crohn's disease--the McGill experience.

U Kopylov1, W Afif2, A Cohen3, A Bitton2, G Wild2, T Bessissow2, J Wyse3, T Al-Taweel2, A Szilagyi3, E Seidman2.   

Abstract

BACKGROUND: Ustekinumab is a fully human IgG1κ monoclonal antibody that blocks the biologic activity of interleukin-12/23. Ustekinumab is approved for treatment of plaque psoriasis and has been shown to be effective for induction and maintenance of clinical response in anti-TNF resistant Crohn's disease (CD). The aim of the study was to describe the real-life experience with open-label use of ustekinumab in anti-TNF resistant CD patients.
METHODS: A retrospective observational open-label study. Clinical response was defined by physician's global assessment combined with decision to continue therapy. The clinical response was evaluated at 3, 6, 12months and last follow-up.
RESULTS: Thirty-eight patients were included in the study. Initial clinical response was achieved in 28/38 (73.7%) of the patients. Among the initial responders, 80% with follow-up data maintained their response for 6months. At 12months of follow-up, 88.9% of patients responding at 6months maintained their response. At the last follow-up (7.9±5.2 mo) 27/38 (71%) of the patients were responding, and 73.3% were able to discontinue corticosteroids. Dose escalation was required in 47.7% of the patients and was successful in 61.1% of them.
SUMMARY: In this real-life cohort of severe anti-TNF resistant CD, an initial clinical response to subcutaneous ustekinumab was observed in 73.7% of the patients. The initial response was successfully maintained in the majority of patients for up to 12months. Subcutaneous ustekinumab is an effective therapeutic option in this challenging patient cohort. The optimal dosing and injection schedule remain to be established in future studies. Crown
Copyright © 2014. Published by Elsevier B.V. All rights reserved.

Entities:  

Keywords:  Biologics; Crohn's disease; TNF-alpha inhibitors; Ustekinumab

Mesh:

Substances:

Year:  2014        PMID: 24996483     DOI: 10.1016/j.crohns.2014.06.005

Source DB:  PubMed          Journal:  J Crohns Colitis        ISSN: 1873-9946            Impact factor:   9.071


  42 in total

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