Ustekinumab for Extra-intestinal Manifestations of Inflammatory Bowel Disease: A Systematic Literature Review

Guillo, Lucas; D’Amico, Ferdinando; Danese, Silvio; Peyrin–Biroulet, Laurent

doi:10.1093/ecco-jcc/jjaa260

Cited by 71 publications

(56 citation statements)

References 44 publications

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“…In a recent systematic review, evidence was provided that ustekinumab can be effective for IBD-associated peripheral arthritis (as well as skin EIMs), but not in axSpA. 54 Tofacitinib is an oral, small molecule that inhibits mainly JAK1 and JAK3 and is available and approved for the treatment of moderately to severely active UC, as well as rheumatoid arthritis and PsA. Phase 3 trials are under way to establish its safety and efficacy in AS.…”

Section: Additional Therapeutic Considerationsmentioning

confidence: 99%

Extraintestinal Manifestations of Inflammatory Bowel Disease: Current Concepts, Treatment, and Implications for Disease Management

et al. 2021

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Inflammatory bowel diseases (IBDs) are systemic diseases that manifest not only in the gut and gastrointestinal tract, but also in the extraintestinal organs in many patients. The quality of life for patients with IBD can be substantially affected by these extraintestinal manifestations (EIMs). It is important to have knowledge of the prevalence, pathophysiology, and clinical presentation of EIMs in order to adapt therapeutic options to cover all aspects of IBD. EIMs can occur in up to 24% of patients with IBD before the onset of intestinal symptoms, and need to be recognized to initiate appropriate diagnostic procedures. EIMs most frequently affect joints, skin, or eyes, but can also affect other organs, such as the liver, lung, and pancreas. It is a frequent misconception that a successful therapy of the intestinal inflammation will be sufficient to treat EIMs satisfactorily in most patients with IBD. In general, peripheral arthritis, oral aphthous ulcers, episcleritis, or erythema nodosum can be associated with active intestinal inflammation and can improve on standard treatment of the intestinal inflammation. However, anterior uveitis, ankylosing spondylitis, and primary sclerosing cholangitis usually occur independent of disease flares. This review provides a comprehensive overview of epidemiology, pathophysiology, clinical presentation, and treatment of EIMs in IBD.

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Section: Additional Therapeutic Considerationsmentioning

confidence: 99%

Extraintestinal Manifestations of Inflammatory Bowel Disease: Current Concepts, Treatment, and Implications for Disease Management

et al. 2021

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“…The available data on vedolizumab do not support its efficacy in this indication. With regard to ustekinumab, some premises exist to suggest its efficacy, although evidence of higher scientific value is still to be obtained [298][299][300]. Upon the diagnosis of CD, a complete medical history should be collected including information on the history of infectious diseases and protective vaccinations.…”

Section: Ix7 Arthropathy Associated With CDmentioning

confidence: 99%

Guidelines for the management of patients with Crohn’s disease. Recommendations of the Polish Society of Gastroenterology and the Polish National Consultant in Gastroenterology

Łodyga¹,

Eder²,

Gawron-Kiszka³

et al. 2021

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This paper is an update of the diagnostic and therapeutic recommendations of the National Consultant for Gastroenterology and the Polish Society of Gastroenterology from 2012. It contains 46 recommendations for the diagnosis and treatment, both pharmacological and surgical, of Crohn's disease in adults. The guidelines were developed by a group of experts appointed by the Polish Society of Gastroenterology and the National Consultant in the field of Gastroenterology. The methodology related to the GRADE methodology was used to assess the quality and strength of the available recommendations. The degree of expert support for the proposed statement, assessment of the quality of evidence and the strength of the recommendation was assessed on a 6-point Likert scale. Voting results, quality and strength ratings with comments are included with each statement.

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“…UST has also demonstrated clinical efficacy in chronic plaque psoriasis or active psoriatic arthritis treatment 14,15 . A systematic review on UST for treatment of EIMs in IBD suggested that UST was effective, in particular for treatment of dermatologic manifestations such as psoriasis, PG and EN, and rheumatologic manifestations such as arthralgias and psoriatic arthritis 16 . However, the existing literature is limited due to mainly retrospective evaluations (eight of nine studies), small sample sizes (total of 254 patients included in the review) and lack of comparator groups.…”

Section: Introductionmentioning

confidence: 99%

“…14,15 A systematic review on UST for treatment of EIMs in IBD suggested that UST was effective, in particular for treatment of dermatologic manifestations such as psoriasis, PG and EN, and rheumatologic manifestations such as arthralgias and psoriatic arthritis. 16 However, the existing literature is limited due to mainly retrospective evaluations (eight of nine studies), small sample sizes (total of 254 patients included in the review) and lack of comparator groups. This post hoc analysis of UNITI-1/2 and IM-UNITI aimed to evaluate the efficacy of UST in treatment of EIMs in moderate-severe CD patients.…”

Section: Introductionmentioning

confidence: 99%

The impact of ustekinumab on extraintestinal manifestations of Crohn's disease: A post hoc analysis of the UNITI studies

et al. 2021

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Summary This post hoc analysis of the UNITI studies found ustekinumab (UST) did not significantly improve overall extraintestinal manifestations (EIMs) of Crohn's disease compared to placebo‐treated patients at weeks 6 and 52. Background and Aims The UNITI trials demonstrated that UST was effective in inducing and maintaining clinical remission in Crohn's disease (CD). However, limited data exists regarding its effectiveness for treatment of EIMs. This post hoc analysis evaluated the efficacy of UST in treatment of EIMs. Methods Data from UNITI‐1/2 and IM‐UNITI (NCT01369329, NCT01369342, NCT01369355) were obtained from the Yale Open Data Access Project (2019‐4104). Nine hundred and fourty‐one patients eligible for UST induction and 263 patients eligible for maintenance UST were included. The primary outcome of interest was EIM resolution at Week 6 in UST and placebo‐treated patients using the chi‐square test. EIM resolution at Week 52 was also assessed. McNemar's test was used to compare the proportion of patients who reported active EIMs at weeks 6 and 52 versus baseline. Results From 941 UST‐treated patients in UNITI‐1/2, 504 had 527 EIMs at baseline. Overall, there was no significant difference in EIM resolution observed in UST‐treated patients (186/504, 36.9%) compared to placebo (90/230, 39.1%; p = 0.564) at Week 6. Patients treated with continuous UST (91/119, 76.4%) had no significant difference in overall EIMs resolved at Week 52 compared to placebo (72/90, 80.0%; p = 0.542). Although many EIMs demonstrated reduction in prevalence compared to baseline at initiation of UST, only erythema nodosum was more likely to improve at Week 52 on treatment versus placebo. Conclusion Overall, UST did not lead to significant resolution of EIMs for CD compared to placebo at weeks 6 and 52.

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Ustekinumab for Extra-intestinal Manifestations of Inflammatory Bowel Disease: A Systematic Literature Review

Cited by 71 publications

References 44 publications

Extraintestinal Manifestations of Inflammatory Bowel Disease: Current Concepts, Treatment, and Implications for Disease Management

Extraintestinal Manifestations of Inflammatory Bowel Disease: Current Concepts, Treatment, and Implications for Disease Management

Guidelines for the management of patients with Crohn’s disease. Recommendations of the Polish Society of Gastroenterology and the Polish National Consultant in Gastroenterology

The impact of ustekinumab on extraintestinal manifestations of Crohn's disease: A post hoc analysis of the UNITI studies

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