Naslov
Effectiveness of ustekinumab dose escalation in Crohn’s disease patients with insufficient response to standard-dose subcutaneous maintenance therapy

Autori
Kopylov, Uri ; Hanzel, Jurij ; Liefferinckx, Claire ; De Marco, Davide ; Imperatore, Nicola ; Plevris, Nikolas ; Baston-Rey, Iria ; Harris, Richard J. ; Truyens, Marie ; Domislovic, Viktor ; Vavricka, Stephan ; Biemans, Vince ; Myers, Sally ; Sebastian, Shaji ; Ben-Horin, Shomron ; González Lama, Yago ; Gilletta, Cyrielle ; Ariella, Bar-Gil Shitrit ; Zelinkova, Zuzana ; Weisshof, Roni ; Storan, Darragh ; Zittan, Eran ; Farkas, Klaudia ; Molnar, Tamas ; Franchimont, Denis ; Cremer, Anneline ; Afif, Waqqas ; Castiglione, Fabiana ; Lees, Charles ; Barreiro-de Acosta, Manuel ; Lobaton, Triana ; Doherty, Glen ; Krznaric, Zeljko ; Pierik, Marieke ; Hoentjen, Frank ; Drobne, David

Izvornik
Alimentary Pharmacology Therapeutics (0269-2813) 52 (2020), 1; 135-142

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
na

Sažetak
Background: Ustekinumab is effective in Crohn's disease. However, a substantial proportion of patients will not respond or lose response to ustekinumab. The current evidence to support the effectiveness of dose-optimisation for ustekinumab nonresponse is limited. Aim: To assess the effectiveness of dose escalation of ustekinumab. Methods: This was a multicentre retrospective cohort study. We included active Crohn's disease patients who received a standard-dose intravenous induction and at least one subcutaneous ustekinumab 90 mg dose. All enrolled patients received dose escalation by either shortening the interval between the doses to every 4 or 6 weeks, intravenous reinduction or a combination of strategies. The primary outcome of the study was clinical response at week 16 after dose escalation. Results: A total of 142 patients (22 centres/14 countries) were included. The patients were dose- escalated after a median treatment duration of 30 weeks. At week 16 from escalation, 73/142 (51.4%) responded to treatment, including 55/142 (38.7%) in clinical remission. Corticosteroid-free remission was achieved in 6/34 (17.6%) patients on corticosteroids at the time of escalation ; 118/142 (83%) continued treatment beyond week 16. Follow-up data beyond week 16 were available for 74/118 (62.7%) patients. On the last follow-up, 51/98 (52%) patients with available data responded to treatment, including 41/98 (42%) in clinical remission. Conclusions: Intensification of ustekinumab maintenance dosage was effective in over 50% of the patients. This strategy should be considered in patients who are nonresponsive to every 8 weeks ustekinumab maintenance dosing.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA