Long-term Maintenance of Clinical, Endoscopic, and Radiographic Response to Ustekinumab in Moderate-to-Severe Crohnʼs Disease

Ma, Christopher; Fedorak, Richard N.; Kaplan, Gilaad G.; Dieleman, Levinus A.; Devlin, Shane; Stern, N; Kroeker, Karen I.; Seow, Cynthia H.; Leung, Yvette; Novak, Kerri L.; Halloran, Brendan P.; Huang, Vivian; Wong, Karen; Blustein, Philip K; Ghosh, Subrata; Panaccione, Remo

doi:10.1097/mib.0000000000001074

Cited by 104 publications

(112 citation statements)

References 29 publications

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“…In contrast, patients with an HBI score ≥ 7 at induction were less likely to achieve clinical response, as were patients with stricturing disease . The same group performed a retrospective cohort study of 104 CD patients who responded to ustekinumab induction and continued long‐term maintenance . Colonic and ileocolonic disease were associated with lower risk for loss of response during maintenance therapy.…”

Section: Resultsmentioning

confidence: 99%

“…Concomitant use of immunosuppressant at baseline was a predictive factor of clinical benefit at 3 months . Ma et al found that concurrent immunomodulator was associated with a reduced risk of loss of response during maintenance treatment but not for induction . However, Battat et al showed similar rates of steroid‐free clinical remission, endoscopic response and remission between patients with or without immunomodulator.…”

Section: Resultsmentioning

confidence: 99%

“…In real‐world observational studies, patients were treated off‐label and received highly variable induction and maintenance dosing, thus limiting the generalisability of results. The rates of response were reported to be as high as 84% and remission rates as high as 35% at end of induction, with loss of response in around one‐third of patients during maintenance …”

Section: Introductionmentioning

confidence: 99%

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Review article: predictors of response to vedolizumab and ustekinumab in inflammatory bowel disease

Barré

Colombel

Ungaro

2018

Aliment Pharmacol Ther

113

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integrin for vedolizumab and interleukin-12/23 pathways for ustekinumab) than the primary biological class, anti-tumour necrosis factor alpha (anti-TNF) agents. As the armamentarium for IBD increases in coming years, it will become important to understand factors associated with response in order to best position and personalise therapy.Aim: To summarise the current data on predictors of response to vedolizumab and ustekinumab in IBD patients. Methods:We conducted a comprehensive literature review. A PubMed search was performed using pre-defined key words and terms to identify relevant studies on predictors of response.Results: Patients with severe disease (by clinical activity and inflammatory biomarkers), or prior anti-TNF exposure are less likely to respond to vedolizumab. Ileocolonic disease, no prior surgery and uncomplicated phenotype were associated with better responses to ustekinumab in CD. Initial response seems to predict a better long-term maintenance in both therapies (P < 0.001). Contrary to anti-TNF therapies, immunogenicity appears to play less of a role in response. Conclusion:As the number of new biological therapies increase in IBD, identifying patients who are most likely to benefit from specific agents is of paramount importance to help best position IBD therapies.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Review article: predictors of response to vedolizumab and ustekinumab in inflammatory bowel disease

Barré

Colombel

Ungaro

2018

Aliment Pharmacol Ther

113

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“…However, there are a few limitations to consider. First, this study only included follow‐up data up to 14 weeks, which is a shorter follow‐up period than a similar previous study by Ma et al. Also, HBI was used to assess clinical response and remission, whereas the UNITI trial used the Crohn's Disease Activity Index.…”

mentioning

confidence: 97%

Editorial: real‐world short‐term effectiveness of ustekinumab in 305 patients with Crohn’s disease—results from the ENEIDA registry

Frasca

Cheifetz

2019

Aliment Pharmacol Ther

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“…Currently, the biologics with regulatory approval for the management of CD include TNF antagonists and ustekinumab, a monoclonal antibody blocking the biological activity of IL-12 and IL-23 [18,19] . Bmi1 expression correlated significantly with TNF-α and IL-23 expression, with a linear coefficient of 0.49 and 0.48, respectively in the colonic mucosa of CD patients ( Fig.…”

Section: Association Between Bmi1 and Cytokines In The Colonic Mucosamentioning

confidence: 99%

Clinical Significance of Bmi1 Expression in Inflammatory Bowel Disease

et al. 2017

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Background: Although the stem cell marker Bmi1 is overexpressed in many malignancies, its role in inflammation-associated cancer is unclear. Colitis-associated cancer (CAC) is caused by chronic intestinal inflammation and often results from refractory inflammatory bowel disease (IBD). Methods: To assess the involvement of Bmi1 in the development of CAC, we analyzed the gene expression of colon tissues collected from 111 patients with IBD and CAC. Results: In the colonic mucosa of patients with ulcerative colitis, the expression of Bmi1 correlated significantly with the expression of inflammatory cytokines such as IL-6, IL-17, IL-23, and tumor necrosis factor α (TNF-α). In the colonic mucosa of patients with Crohn's disease, the expression of Bmi1 correlated significantly with the expression of TNF-α and IL-23. The expression of Bmi1 was enhanced in the colonic mucosae of refractory IBD, suggesting that Bmi1 expression might be related to increased cancer risk. In addition, patients with high Bmi1 expression showed significantly lower response rates upon subsequent anti-TNF-α therapy as compared to patients with low Bmi1 expression. In human CAC specimens, the expression of Bmi1 was upregulated in nontumor tissues as well as tumors. Conclusions: Bmi1 expression is related to a refractory clinical course of IBD and upregulated in refractory IBD and CAC. Measurement of Bmi1 expression is a promising approach for the advanced treatment and personalized management of IBD patients.

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Long-term Maintenance of Clinical, Endoscopic, and Radiographic Response to Ustekinumab in Moderate-to-Severe Crohnʼs Disease

Abstract: Subcutaneous ustekinumab is an effective treatment option for maintaining long-term clinical, endoscopic, and radiographic response in patients with moderate-to-severe CD failing antitumor necrosis factor therapy.

Cited by 104 publications

References 29 publications

Review article: predictors of response to vedolizumab and ustekinumab in inflammatory bowel disease

Review article: predictors of response to vedolizumab and ustekinumab in inflammatory bowel disease

Editorial: real‐world short‐term effectiveness of ustekinumab in 305 patients with Crohn’s disease—results from the ENEIDA registry

Clinical Significance of Bmi1 Expression in Inflammatory Bowel Disease

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