Ustekinumab Induction and Maintenance Therapy in Refractory Crohn's Disease

In this randomized trial involving adults with Crohn's disease in whom anti–tumor necrosis factor therapy had failed, ustekinumab, an antibody against interleukin-12 and 23, was associated with increased response rates, as compared with placebo. Crohn's disease is a chronic inflammatory bowel disease. 1 One third of patients do not have a response to initial treatment with tumor necrosis factor (TNF) antagonists (primary nonresponse) 2 – 6 ; another one third have a transient response 2 , 4 , 6 and require dose escalation or a switch to another therapy (secondary nonresponse). 7 , 8 Patients with primary nonresponse are unlikely to benefit from another TNF antagonist. Patients with secondary nonresponse who switch to a second TNF antagonist are less likely to have a response than are patients who have not received a TNF antagonist. 4 , 6 These represent difficult clinical problems. Preclinical studies . . .