P510 Comparative effectiveness of Ustekinumab against other biologics in Inflammatory Bowel Disease: a propensity score analysis.

Abstract

Background Background: Increasing evidence supports the use of Ustekinumab (USTK) in patients with moderate to severe Crohn’s disease (CD) and Ulcerative colitis (UC). Comparison of USTK against other biologics is still lacking. Methods AIMS: to perform a propensity score analysis (PSA) for comparison of USTK against conventional Infliximab (IFX), proactive IFX and vedolizumab in CD and UC Methods retrospective study including patients under Ustekinumab (n=71), Vedolizumab (n=98), conventional IFX (n=70) and proactive IFX (n=148). PSA correcting for age, gender, IBD subtype, previous biologic exposure was performed for each comparison. We compared the rates of fecal calprotectin (Fc) remission (<150 µg/g), treatment discontinuation, hospitalization, and surgery at 52 weeks of treatment. Primary non-responders were excluded. Results Results: after PSP, ustekinumab showed lower rates of treatment discontinuation compared to vedolizumab (7.4% vs 37%, P< 0.001) with a trend for higher rates of Fc remission (42.6% vs 25.9%, P=0.104). Ustekinumab showed higher rates of Fc remission compared to conventional IFX (53.8% vs 19.2%, P= 0.020) with a trend for lower rates of hospitalization (7.7% vs 30.8%, P= 0.075). There were no differences between ustekinumab and proactive IFX in any of the clinical outcomes. Conclusion Conclusion: taking into account the potential limitations of PSP, our results suggest that ustekinumab may be as effective as proactive IFX with some benefits compared to vedolizumab and conventional IFX.

A bibliometric and visual analysis of the use of ustekinumab in Crohn’s disease using CiteSpace

“…The effectiveness of FC in the prediction of endoscopic and histologic activity of IBD, and disease recurrence has been the subject of numerous investigations ( Khaki-Khatibi et al, 2020 ). UST showed significantly higher FC remission rates compared to conventional IFX (53.8% vs. 19.2%, p = 0.020), and there was a trend towards lower hospitalization rates (7.7% vs. 30.8%, p = 0.075) in a propensity score analysis comparing UST to Infliximab and vedolizumab in CD from the ECCO conference ( Matos Coelho Bernardo et al, 2023 ). However, available data on the degree to which FC levels can be used to predict the endoscopic response or histologic remission in UST-treated patients still lacks.…”