Real-life effectiveness of ustekinumab in inflammatory bowel disease patients with concomitant psoriasis or psoriatic arthritis: An IG-IBD study

Pugliese, Daniela; Fiorino, Gionata; Savarino, Edoardo; Mosso, Elena; Biancone, Livia; Testa, Anna; Sarpi, Lucio; Cappello, Maria; Bodini, Giorgia; Caprioli, Flavio; Festa, Stefano; Laino, G; Maconi, Giovanni; Mazzuoli, S.; Mocci, Giammarco; Sartini, Alessandro; D'Amore, Alessandra; Alivernini, Stefano; Gremese, Elisa; Armuzzi, Alessandro

doi:10.1016/j.dld.2019.03.007

Cited by 31 publications

(20 citation statements)

References 32 publications

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“…Two studies including a total of 229 patients with CD were analyzed. 39,40 On meta-analysis, combination therapy was not associated with better endoscopic outcome as compared with monotherapy (OR, 0.58; 95% CI, 0.21-1.16), with moderate heterogeneity (I 2 ¼ 47%, Q test P ¼ .167).…”

Section: Endoscopic Remissionmentioning

confidence: 98%

“…Of 417 unique studies identified using our search strategy, 13 studies were included. 7,8,[36][37][38][39][40][41][42][43][44][45][46] Two studies could be included after contacting the authors (Supplementary Figure 10). 47,48 Table 2 shows their main characteristics.…”

Section: Ustekinumabmentioning

confidence: 99%

“…Fifteen studies including a total of 2786 patients were included. 7,8,[36][37][38][39][40][41][42][43][44][45][46][47][48] Two studies were included with UC, 37,45 and finally a total of 2458 and 328 CD and UC patients, respectively, were included. Overall, 856 and 1926 patients with combination therapy and monotherapy, respectively, were included.…”

Section: Ustekinumabmentioning

confidence: 99%

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Long-Term Obeticholic Acid Therapy Improves Histological Endpoints in Patients With Primary Biliary Cholangitis

Bowlus

Pockros

Kremer

et al. 2020

Clinical Gastroenterology and Hepatology

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BACKGROUND & AIMS:There is debate over whether patients with inflammatory bowel diseases (IBD) treated with biologics that are not tumor necrosis factor antagonists (such as vedolizumab or ustekinumab) should receive concomitant treatment with immunomodulators. We conducted a meta-analysis to compare the efficacy and safety of concomitant immunomodulator therapy vs vedolizumab or ustekinumab monotherapy. METHODS:In a systematic search of publications, through July 31, 2019, we identified 33 studies (6 randomized controlled trials and 27 cohort studies) of patients with IBD treated with vedolizumab or ustekinumab. The primary outcome was clinical benefit, including clinical remission, clinical response, or physician global assessment in patients who did vs did not receive combination therapy with an immunomodulator. Secondary outcomes were endoscopic improvement and safety. We performed random-effects meta-analysis and estimated odds ratio (OR) and 95% CIs. RESULTS:Overall, combination therapy was not associated with better clinical outcomes in patients receiving vedolizumab (16 studies: OR, 0.84; 95% CI, 0.68-1.05; I2[13.9%; Q test P [ .17) or ustekinumab (15 studies: OR, 1.1; 95% CI, 0.87-1.38; I2 [ 11%; Q test P [ .28). Results were consistent in subgroup analyses, with no difference in clinical remission or response in induction vs maintenance studies or in patients with Crohn's disease vs ulcerative colitis in studies of vedolizumab. Combination therapy was not associated with better endoscopic outcomes in patients receiving vedolizumab (3 studies: OR, 1.13; 95% CI, 0.48-2.68; I2 [ 0; Q test P[.96) or ustekinumab (2 studies: OR, 0.58; 95% CI, 0.21-1.16; I2 [ 47%; Q test P [ .17). Combination therapy was not associated with an increase in adverse events during vedolizumab therapy (4 studies: OR, 1.17; 95% CI, 0.75-1.84; I2 [ 0; Q test P [ .110). CONCLUSIONS:In a meta-analysis of data from studies of patients with IBD, we found that combining vedolizumab or ustekinumab with an immunomodulator is no more effective than monotherapy in induction or maintenance of remission.

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Section: Endoscopic Remissionmentioning

confidence: 98%

Section: Ustekinumabmentioning

confidence: 99%

Section: Ustekinumabmentioning

confidence: 99%

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Long-Term Obeticholic Acid Therapy Improves Histological Endpoints in Patients With Primary Biliary Cholangitis

Bowlus

Pockros

Kremer

et al. 2020

Clinical Gastroenterology and Hepatology

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“… 109 – 111 For patients with concomitant psoriasis (including paradoxical), swap to ustekinumab has been reported to be safe and effective. 112 Furthermore, ustekinumab has been reported to be superior compared with in-class switch in case of paradoxical psoriasis. 111 A few cases of patients where ustekinumab was added to anti-TNFα have also been reported, with five out of eight patients reporting clinical benefit.…”

Section: Combination and Sequential Therapies For A Dynamic Management Of Ibdmentioning

confidence: 99%

Novel trends with biologics in inflammatory bowel disease: sequential and combined approaches

Privitera

Pugliese

Lopetuso

et al. 2021

Therap Adv Gastroenterol

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Inflammatory bowel disease (IBD) management has changed dramatically over the past 20 years, after the introduction of targeted biological therapies. However, the impact of these new drugs in changing the natural history of disease is still under debate. Recent evidence seems to suggest that the extent of their efficacy might be, at least partially, dependent on the timing of their introduction and on the subsequent management strategy. In this complex landscape, the potential role for a more dynamic approach with treatments based on sequencing and combining targeted therapies has been explored only minimally so far. In this review, we aim to explore the potential biological rationale behind the use of sequential and combination therapies in IBD, to summarise the current knowledge on this topic and to propose a management algorithm that combines these notions.

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“…The pathological process of IBD ranges from active stage to remission stage, and an effective therapeutic strategy is to control the active phase of the illness. 92,93 The injury of intestinal vascular endothelial cells during the active stage is chiefly because of the sustained inflammation and oxidative stress. Therefore, anti-inflammatory and antioxidant therapy on IBD is very important.…”

Section: Effec Ts Of S1pr Reg Ul Ator S On Inte S Tinal Ve Ss El S mentioning

confidence: 99%

Role of sphingosine‐1‐phosphate receptors in vascular injury of inflammatory bowel disease

Wang

Chen

Xiang

et al. 2021

J Cellular Molecular Medi

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Sphingosine‐1‐phosphate receptors (S1PRs) have an impact on the intestinal inflammation of inflammatory bowel disease (IBD) by regulating lymphocyte migration and differentiation. S1PR modulators as an emerging therapeutic approach are being investigated for the treatment of IBD. However, the role of S1PRs in intestinal vessels has not drawn much attention. Intestinal vascular damage is one of the major pathophysiological features of IBD, characterized by increased vascular density and impaired barrier function. S1PRs have pleiotropic effects on vascular endothelial cells, including proliferation, migration, angiogenesis and barrier homeostasis. Mounting evidence shows that S1PRs are abnormally expressed on intestinal vascular endothelial cells in IBD. Unexpectedly, S1PR modulators may damage intestinal vasculature, for example increase intestinal bleeding; therefore, S1PRs are thought to be involved in the regulation of intestinal vascular function in IBD. However, little is understood about how S1PRs regulate intestinal vascular function and participate in the initiation and progression of IBD. In this review, we summarize the pathogenic role of S1PRs in and the underlying mechanisms behind the intestinal vascular injury in IBD in order for improving IBD practice including S1PR‐targeted therapies.

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Real-life effectiveness of ustekinumab in inflammatory bowel disease patients with concomitant psoriasis or psoriatic arthritis: An IG-IBD study

Cited by 31 publications

References 32 publications

Long-Term Obeticholic Acid Therapy Improves Histological Endpoints in Patients With Primary Biliary Cholangitis

Long-Term Obeticholic Acid Therapy Improves Histological Endpoints in Patients With Primary Biliary Cholangitis

Novel trends with biologics in inflammatory bowel disease: sequential and combined approaches

Role of sphingosine‐1‐phosphate receptors in vascular injury of inflammatory bowel disease

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