A critical review of ustekinumab for the treatment of active ulcerative colitis in adults

Vieujean, Sophie; Louis, Édouard; Danese, Silvio; Peyrin–Biroulet, Laurent

doi:10.1080/17474124.2023.2194632

Cited by 3 publications

(2 citation statements)

References 116 publications

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“…Ustekinumab has demonstrated effectiveness in inducing and maintaining clinical, endoscopic, and histologic remission in moderate-to-severe UC in both phase 3 clinical trials and realworld studies. The favorable risk-benefit ratio, efficacy on extra-intestinal manifestations, and effectiveness in patients who have failed other biologics position ustekinumab as an ideal candidate for first-, second-, or third-line therapy in UC [323]. For patients on ustekinumab therapy, the decision on whether to continue without endoscopic response evaluation may be considered in those with a decrease in fecal calprotectin (FC) levels of ≥500 µg/g at week 8.…”

Section: Il-12/il-23 Inhibitorsmentioning

confidence: 99%

A Narrative Review of Cytokine Networks: Pathophysiological and Therapeutic Implications for Inflammatory Bowel Disease Pathogenesis

Vebr,

Pomahačová,

Sýkora

et al. 2023

Biomedicines

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Inflammatory bowel disease (IBD) is a lifelong inflammatory immune mediated disorder, encompassing Crohn’s disease (CD) and ulcerative colitis (UC); however, the cause and specific pathogenesis of IBD is yet incompletely understood. Multiple cytokines produced by different immune cell types results in complex functional networks that constitute a highly regulated messaging network of signaling pathways. Applying biological mechanisms underlying IBD at the single omic level, technologies and genetic engineering enable the quantification of the pattern of released cytokines and new insights into the cytokine landscape of IBD. We focus on the existing literature dealing with the biology of pro- or anti-inflammatory cytokines and interactions that facilitate cell-based modulation of the immune system for IBD inflammation. We summarize the main roles of substantial cytokines in IBD related to homeostatic tissue functions and the remodeling of cytokine networks in IBD, which may be specifically valuable for successful cytokine-targeted therapies via marketed products. Cytokines and their receptors are validated targets for multiple therapeutic areas, we review the current strategies for therapeutic intervention and developing cytokine-targeted therapies. New biologics have shown efficacy in the last few decades for the management of IBD; unfortunately, many patients are nonresponsive or develop therapy resistance over time, creating a need for novel therapeutics. Thus, the treatment options for IBD beyond the immune-modifying anti-TNF agents or combination therapies are expanding rapidly. Further studies are needed to fully understand the immune response, networks of cytokines, and the direct pathogenetic relevance regarding individually tailored, safe and efficient targeted-biotherapeutics.

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Section: Il-12/il-23 Inhibitorsmentioning

confidence: 99%

A Narrative Review of Cytokine Networks: Pathophysiological and Therapeutic Implications for Inflammatory Bowel Disease Pathogenesis

Vebr,

Pomahačová,

Sýkora

et al. 2023

Biomedicines

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“…In a meta-evaluation of ustekinumab for UC, it was found that this agent has demonstrated efficacy and safety in both randomized controlled trials (RCTs) and real clinical practice [9]. The most common adverse event reported with ustekinumab was infection, with rates of 34% and 41% in the ustekinumab and adalimumab groups, respectively [10]. Another study by Moens et al reported similar findings, with eight events of infections in the ustekinumab group and ten events in the adalimumab group [11].…”

Section: Introductionmentioning

confidence: 99%

Network meta-analysis on efficacy and safety of different biologics for ulcerative colitis

Chu,

Biao,

Liu

et al. 2023

BMC Gastroenterol

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Background Therapeutic options for ulcerative colitis (UC) have increased since the introduction of biologics a few decades ago. Due to the wide range of biologics available, physicians have difficulty in selecting biologics and do not know how to balance the best drug between clinical efficacy and safety. This study aimed to compare the efficacy and safety of biologics in treating ulcerative colitis. Methods In this study, eight electronic databases (PubMed, Web of Science, Cochrane, Embase, Sinomed, China National Knowledge Infrastructure, Chongqing VIP Information, and WanFang Data) were searched to collect eligible studies without language restrictions. Retrieved 1 June 2023, from inception. All articles included in the mesh analysis are randomised controlled trials (RCTs). The inclusion of drugs for each outcome was ranked using a curved surface under cumulative ranking (SUCRA). Higher SUCRA scores were associated with better outcomes, whereas lower SUCRA scores were associated with better safety. This study has registered with PROSPERO, CRD42023389483. Results Induction Therapy: Among the biologic therapies evaluated for induction therapy, vedolizumab demonstrated the highest efficacy in achieving clinical remission (OR vs daclizumab, 9.09; 95% CI, 1.01–81.61; SUCRA 94.1) and clinical response. Guselkumab showed the lowest risk of recurrence of UC (SUCRA 94.9%), adverse events resulting in treatment discontinuation (SUCRA 94.8%), and serious infections (SUCRA 78.0%). Maintenance Therapy: For maintenance therapy, vedolizumab ranked highest in maintaining clinical remission (OR vs mesalazine 4.36; 95% CI, 1.65–11.49; SUCRA 89.7) and endoscopic improvement (SUCRA 92.6). Infliximab demonstrated the highest efficacy in endoscopic improvement (SUCRA 92.6%). Ustekinumab had the lowest risk of infections (SUCRA 92.9%), serious adverse events (SUCRA 91.3%), and serious infections (SUCRA 67.6%). Conclusion Our network meta-analysis suggests that vedolizumab is the most effective biologic therapy for inducing and maintaining clinical remission in UC patients. Guselkumab shows promise in reducing the risk of recurrence and adverse events during induction therapy. Infliximab is effective in improving endoscopic outcomes during maintenance therapy. Ustekinumab appears to have a favorable safety profile. These findings provide valuable insights for clinicians in selecting the most appropriate biologic therapy for UC patients.

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Recent advances in nanocarrier systems for ulcerative colitis: A new era of targeted therapy and biomarker integration

Chauhan,

Harwansh

2024

Journal of Drug Delivery Science and Technology

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A critical review of ustekinumab for the treatment of active ulcerative colitis in adults

Cited by 3 publications

References 116 publications

A Narrative Review of Cytokine Networks: Pathophysiological and Therapeutic Implications for Inflammatory Bowel Disease Pathogenesis

A Narrative Review of Cytokine Networks: Pathophysiological and Therapeutic Implications for Inflammatory Bowel Disease Pathogenesis

Network meta-analysis on efficacy and safety of different biologics for ulcerative colitis

Recent advances in nanocarrier systems for ulcerative colitis: A new era of targeted therapy and biomarker integration

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