Effectiveness of swapping to ustekinumab after vedolizumab failure in patients with multi-refractory Crohn?s disease

被引:1
作者
Melotti, Laura [1 ,2 ]
Dussias, Nikolas Konstantine [1 ,2 ]
Salice, Marco [1 ]
Calabrese, Carlo [1 ,2 ]
Baldoni, Monia [3 ]
Scaioli, Eleonora [1 ]
Belluzzi, Andrea [1 ]
Mazzotta, Elena [1 ]
Gionchetti, Paolo [1 ,2 ,4 ]
Rizzello, Fernando [1 ,2 ]
机构
[1] Azienda Osped Univ Bologna, IRCCS, IBD Unit, Bologna, Italy
[2] Univ Bologna, Alma Mater Studiorum, Bologna, Italy
[3] Univ Perugia, Sez Gastroenterol, DIMEC, Perugia, Italy
[4] IRCCS Azienda Osped Univ Sant Orsola Malpighi, IBD Unit, Via Massarenti 9, I-40128 Bologna, BO, Italy
关键词
Anti-TNF failure; Clinical remission; Endoscopic activity; Third-line biologics; INFLAMMATORY-BOWEL-DISEASE; ANTI-TNF; EFFICACY; METAANALYSIS; MAINTENANCE; INFLIXIMAB; INDUCTION; THERAPY;
D O I
10.1016/j.dld.2022.06.029
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background: Ustekinumab (UST) and vedolizumab (VDZ) are biologic therapies for moderate-to-severe Crohn's disease (CD) in patients who failed or had contraindication to anti-TNF treatment. Aims: To evaluate ustekinumab efficacy as third-line treatment after swapping from VDZ for failure. Methods:We conducted a monocentric, retrospective, observational study where CD patients were fol-lowed for 12 months from the beginning of UST therapy. We assessed clinical activity (HBI) and laboratory markers (CRP) at the initiation of UST therapy (T0) and after 2(T2), 6(T6) and 12(T12) months. Endoscopic activity was recorded at T0 and T12. We registered data regarding their clinical history and previous biologic treatments. Steroid-free clinical remission was defined as HBI <= 4 without need for steroids. Clinical response was defined as HBI reduction of at least three points or the suspension of steroids.Results: 27 CD patients treated with UST after VDZ failure had a minimum follow up of 12 months and were included. All patients had previously been treated with anti-TNF agents. After 12 months, steroid -free clinical remission was evident in 15 (55.5%) patients, 5 (18.5%) had clinical response, while 7 (26%) had suspended for failure or persisted on treatment after optimization.Conclusions: Ustekinumab should be considered as third-line biologic treatment in multi-refractory CD patients.(c) 2022 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:230 / 234
页数:5
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