Effectiveness of ustekinumab dose escalation in Crohn’s disease patients with insufficient response to standard‐dose subcutaneous maintenance therapy
Summary Background Ustekinumab is effective in Crohn's disease. However, a substantial proportion of patients will not respond or lose response to ustekinumab. The current evidence to support the effectiveness of dose‐optimisation for ustekinumab nonresponse is limited. Aim To assess the effect...
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| Veröffentlicht in: | Alimentary pharmacology & therapeutics 2020-07, Vol.52 (1), p.135-142 |
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| creator | Kopylov, Uri Hanzel, Jurij Liefferinckx, Claire De Marco, Davide Imperatore, Nicola Plevris, Nikolas Baston‐Rey, Iria Harris, Richard J. Truyens, Marie Domislovic, Viktor Vavricka, Stephan Biemans, Vince Myers, Sally Sebastian, Shaji Ben‐Horin, Shomron González Lama, Yago Gilletta, Cyrielle Ariella, Bar‐Gil Shitrit Zelinkova, Zuzana Weisshof, Roni Storan, Darragh Zittan, Eran Farkas, Klaudia Molnar, Tamas Franchimont, Denis Cremer, Anneline Afif, Waqqas Castiglione, Fabiana Lees, Charles Barreiro‐de Acosta, Manuel Lobaton, Triana Doherty, Glen Krznaric, Zeljko Pierik, Marieke Hoentjen, Frank Drobne, David |
| description | Summary
Background
Ustekinumab is effective in Crohn's disease. However, a substantial proportion of patients will not respond or lose response to ustekinumab. The current evidence to support the effectiveness of dose‐optimisation for ustekinumab nonresponse is limited.
Aim
To assess the effectiveness of dose escalation of ustekinumab.
Methods
This was a multicentre retrospective cohort study. We included active Crohn's disease patients who received a standard‐dose intravenous induction and at least one subcutaneous ustekinumab 90 mg dose. All enrolled patients received dose escalation by either shortening the interval between the doses to every 4 or 6 weeks, intravenous reinduction or a combination of strategies. The primary outcome of the study was clinical response at week 16 after dose escalation.
Results
A total of 142 patients (22 centres/14 countries) were included. The patients were dose‐escalated after a median treatment duration of 30 weeks. At week 16 from escalation, 73/142 (51.4%) responded to treatment, including 55/142 (38.7%) in clinical remission. Corticosteroid‐free remission was achieved in 6/34 (17.6%) patients on corticosteroids at the time of escalation; 118/142 (83%) continued treatment beyond week 16. Follow‐up data beyond week 16 were available for 74/118 (62.7%) patients. On the last follow‐up, 51/98 (52%) patients with available data responded to treatment, including 41/98 (42%) in clinical remission.
Conclusions
Intensification of ustekinumab maintenance dosage was effective in over 50% of the patients. This strategy should be considered in patients who are nonresponsive to every 8 weeks ustekinumab maintenance dosing. |
| doi_str_mv | 10.1111/apt.15784 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_webof</sourceid><recordid>TN_cdi_webofscience_primary_000532797200001CitationCount</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2404050457</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3884-bff3105f39211f0fbcf0cbc000ad9174b20a7df9bf0af1edec680390e01a1c023</originalsourceid><addsrcrecordid>eNqNkc9u1DAQxiMEokvhwAsgS1yo0LZjO3-PVdQCUiU4lHPkOGOtS2KHjNNqb30Ern29PgnezdIDEhK-2Jr5zadv_CXJWw6nPJ4zNYZTnhVl-ixZcZlnawEyf56sQOTVWpRcHiWviG4AIC9AvEyOpEi54DJdJQ8XxqAO9hYdEjFv2EwBf1g3D6plnSdkSFr1KljvmHWsnvzGPd4_EOssoYr9MfbQBWJ3NmwiQrMxVu9KbEIavYtM8IyCcp2ausf7X3tZmls9xxr6mdigrAvolNOR3eCkxu3r5IVRPeGbw32cfL-8uK4_r6--fvpSn1-ttSzLdN0aIzlkRlaCcwOm1QZ0q-Ouqqt4kbYCVNGZqjWgDMcOdV6CrACBK65ByOPkw6I7Tv7njBSawZLGvl-sNSKFFDJIsyKi7_9Cb_w8ueguUpxXwIWQkTpZKD15oglNM052UNO24dDs8mpiXs0-r8i-OyjO7YDdE_knoAiUC3CHrTe0-1aNT1jcMpOiqAoRX8BrG_Y51X52IY5-_P_RSJ8daNvj9t-Wm_Nv14v33wFTxeA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2411901223</pqid></control><display><type>article</type><title>Effectiveness of ustekinumab dose escalation in Crohn’s disease patients with insufficient response to standard‐dose subcutaneous maintenance therapy</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Access via Wiley Online Library</source><source>Web of Science - Science Citation Index Expanded - 2020<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><source>Wiley Online Library (Open Access Collection)</source><creator>Kopylov, Uri ; Hanzel, Jurij ; Liefferinckx, Claire ; De Marco, Davide ; Imperatore, Nicola ; Plevris, Nikolas ; Baston‐Rey, Iria ; Harris, Richard J. ; Truyens, Marie ; Domislovic, Viktor ; Vavricka, Stephan ; Biemans, Vince ; Myers, Sally ; Sebastian, Shaji ; Ben‐Horin, Shomron ; González Lama, Yago ; Gilletta, Cyrielle ; Ariella, Bar‐Gil Shitrit ; Zelinkova, Zuzana ; Weisshof, Roni ; Storan, Darragh ; Zittan, Eran ; Farkas, Klaudia ; Molnar, Tamas ; Franchimont, Denis ; Cremer, Anneline ; Afif, Waqqas ; Castiglione, Fabiana ; Lees, Charles ; Barreiro‐de Acosta, Manuel ; Lobaton, Triana ; Doherty, Glen ; Krznaric, Zeljko ; Pierik, Marieke ; Hoentjen, Frank ; Drobne, David</creator><creatorcontrib>Kopylov, Uri ; Hanzel, Jurij ; Liefferinckx, Claire ; De Marco, Davide ; Imperatore, Nicola ; Plevris, Nikolas ; Baston‐Rey, Iria ; Harris, Richard J. ; Truyens, Marie ; Domislovic, Viktor ; Vavricka, Stephan ; Biemans, Vince ; Myers, Sally ; Sebastian, Shaji ; Ben‐Horin, Shomron ; González Lama, Yago ; Gilletta, Cyrielle ; Ariella, Bar‐Gil Shitrit ; Zelinkova, Zuzana ; Weisshof, Roni ; Storan, Darragh ; Zittan, Eran ; Farkas, Klaudia ; Molnar, Tamas ; Franchimont, Denis ; Cremer, Anneline ; Afif, Waqqas ; Castiglione, Fabiana ; Lees, Charles ; Barreiro‐de Acosta, Manuel ; Lobaton, Triana ; Doherty, Glen ; Krznaric, Zeljko ; Pierik, Marieke ; Hoentjen, Frank ; Drobne, David</creatorcontrib><description>Summary
Background
Ustekinumab is effective in Crohn's disease. However, a substantial proportion of patients will not respond or lose response to ustekinumab. The current evidence to support the effectiveness of dose‐optimisation for ustekinumab nonresponse is limited.
Aim
To assess the effectiveness of dose escalation of ustekinumab.
Methods
This was a multicentre retrospective cohort study. We included active Crohn's disease patients who received a standard‐dose intravenous induction and at least one subcutaneous ustekinumab 90 mg dose. All enrolled patients received dose escalation by either shortening the interval between the doses to every 4 or 6 weeks, intravenous reinduction or a combination of strategies. The primary outcome of the study was clinical response at week 16 after dose escalation.
Results
A total of 142 patients (22 centres/14 countries) were included. The patients were dose‐escalated after a median treatment duration of 30 weeks. At week 16 from escalation, 73/142 (51.4%) responded to treatment, including 55/142 (38.7%) in clinical remission. Corticosteroid‐free remission was achieved in 6/34 (17.6%) patients on corticosteroids at the time of escalation; 118/142 (83%) continued treatment beyond week 16. Follow‐up data beyond week 16 were available for 74/118 (62.7%) patients. On the last follow‐up, 51/98 (52%) patients with available data responded to treatment, including 41/98 (42%) in clinical remission.
Conclusions
Intensification of ustekinumab maintenance dosage was effective in over 50% of the patients. This strategy should be considered in patients who are nonresponsive to every 8 weeks ustekinumab maintenance dosing.</description><identifier>ISSN: 0269-2813</identifier><identifier>EISSN: 1365-2036</identifier><identifier>DOI: 10.1111/apt.15784</identifier><identifier>PMID: 32412134</identifier><language>eng</language><publisher>HOBOKEN: Wiley</publisher><subject><![CDATA[Administration, Intravenous ; Adult ; Corticosteroids ; Crohn Disease - drug therapy ; Crohn's disease ; Crohns disease ; Dosage ; Drug dosages ; Female ; Gastroenterology & Hepatology ; Gastrointestinal Agents - administration & dosage ; Humans ; Immunotherapy ; Injections, Subcutaneous ; Intravenous administration ; Life Sciences & Biomedicine ; Maintenance Chemotherapy ; Male ; Middle Aged ; Monoclonal antibodies ; Patients ; Pharmacology & Pharmacy ; Remission ; Remission Induction ; Retrospective Studies ; Science & Technology ; Treatment Outcome ; Ustekinumab - administration & dosage]]></subject><ispartof>Alimentary pharmacology & therapeutics, 2020-07, Vol.52 (1), p.135-142</ispartof><rights>2020 John Wiley & Sons Ltd</rights><rights>2020 John Wiley & Sons Ltd.</rights><rights>Copyright © 2020 John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>54</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000532797200001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c3884-bff3105f39211f0fbcf0cbc000ad9174b20a7df9bf0af1edec680390e01a1c023</citedby><cites>FETCH-LOGICAL-c3884-bff3105f39211f0fbcf0cbc000ad9174b20a7df9bf0af1edec680390e01a1c023</cites><orcidid>0000-0002-3670-6545 ; 0000-0002-1361-8868 ; 0000-0003-3230-6832 ; 0000-0002-7156-0588 ; 0000-0003-3378-4932 ; 0000-0002-3229-8759 ; 0000-0001-5314-4452 ; 0000-0002-1264-4319 ; 0000-0002-3715-5730 ; 0000-0003-3158-8014 ; 0000-0003-1817-7704 ; 0000-0003-4384-5049</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fapt.15784$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fapt.15784$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,1434,27929,27930,28253,45579,45580,46414,46838</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32412134$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kopylov, Uri</creatorcontrib><creatorcontrib>Hanzel, Jurij</creatorcontrib><creatorcontrib>Liefferinckx, Claire</creatorcontrib><creatorcontrib>De Marco, Davide</creatorcontrib><creatorcontrib>Imperatore, Nicola</creatorcontrib><creatorcontrib>Plevris, Nikolas</creatorcontrib><creatorcontrib>Baston‐Rey, Iria</creatorcontrib><creatorcontrib>Harris, Richard J.</creatorcontrib><creatorcontrib>Truyens, Marie</creatorcontrib><creatorcontrib>Domislovic, Viktor</creatorcontrib><creatorcontrib>Vavricka, Stephan</creatorcontrib><creatorcontrib>Biemans, Vince</creatorcontrib><creatorcontrib>Myers, Sally</creatorcontrib><creatorcontrib>Sebastian, Shaji</creatorcontrib><creatorcontrib>Ben‐Horin, Shomron</creatorcontrib><creatorcontrib>González Lama, Yago</creatorcontrib><creatorcontrib>Gilletta, Cyrielle</creatorcontrib><creatorcontrib>Ariella, Bar‐Gil Shitrit</creatorcontrib><creatorcontrib>Zelinkova, Zuzana</creatorcontrib><creatorcontrib>Weisshof, Roni</creatorcontrib><creatorcontrib>Storan, Darragh</creatorcontrib><creatorcontrib>Zittan, Eran</creatorcontrib><creatorcontrib>Farkas, Klaudia</creatorcontrib><creatorcontrib>Molnar, Tamas</creatorcontrib><creatorcontrib>Franchimont, Denis</creatorcontrib><creatorcontrib>Cremer, Anneline</creatorcontrib><creatorcontrib>Afif, Waqqas</creatorcontrib><creatorcontrib>Castiglione, Fabiana</creatorcontrib><creatorcontrib>Lees, Charles</creatorcontrib><creatorcontrib>Barreiro‐de Acosta, Manuel</creatorcontrib><creatorcontrib>Lobaton, Triana</creatorcontrib><creatorcontrib>Doherty, Glen</creatorcontrib><creatorcontrib>Krznaric, Zeljko</creatorcontrib><creatorcontrib>Pierik, Marieke</creatorcontrib><creatorcontrib>Hoentjen, Frank</creatorcontrib><creatorcontrib>Drobne, David</creatorcontrib><title>Effectiveness of ustekinumab dose escalation in Crohn’s disease patients with insufficient response to standard‐dose subcutaneous maintenance therapy</title><title>Alimentary pharmacology & therapeutics</title><addtitle>ALIMENT PHARM THER</addtitle><addtitle>Aliment Pharmacol Ther</addtitle><description>Summary
Background
Ustekinumab is effective in Crohn's disease. However, a substantial proportion of patients will not respond or lose response to ustekinumab. The current evidence to support the effectiveness of dose‐optimisation for ustekinumab nonresponse is limited.
Aim
To assess the effectiveness of dose escalation of ustekinumab.
Methods
This was a multicentre retrospective cohort study. We included active Crohn's disease patients who received a standard‐dose intravenous induction and at least one subcutaneous ustekinumab 90 mg dose. All enrolled patients received dose escalation by either shortening the interval between the doses to every 4 or 6 weeks, intravenous reinduction or a combination of strategies. The primary outcome of the study was clinical response at week 16 after dose escalation.
Results
A total of 142 patients (22 centres/14 countries) were included. The patients were dose‐escalated after a median treatment duration of 30 weeks. At week 16 from escalation, 73/142 (51.4%) responded to treatment, including 55/142 (38.7%) in clinical remission. Corticosteroid‐free remission was achieved in 6/34 (17.6%) patients on corticosteroids at the time of escalation; 118/142 (83%) continued treatment beyond week 16. Follow‐up data beyond week 16 were available for 74/118 (62.7%) patients. On the last follow‐up, 51/98 (52%) patients with available data responded to treatment, including 41/98 (42%) in clinical remission.
Conclusions
Intensification of ustekinumab maintenance dosage was effective in over 50% of the patients. This strategy should be considered in patients who are nonresponsive to every 8 weeks ustekinumab maintenance dosing.</description><subject>Administration, Intravenous</subject><subject>Adult</subject><subject>Corticosteroids</subject><subject>Crohn Disease - drug therapy</subject><subject>Crohn's disease</subject><subject>Crohns disease</subject><subject>Dosage</subject><subject>Drug dosages</subject><subject>Female</subject><subject>Gastroenterology & Hepatology</subject><subject>Gastrointestinal Agents - administration & dosage</subject><subject>Humans</subject><subject>Immunotherapy</subject><subject>Injections, Subcutaneous</subject><subject>Intravenous administration</subject><subject>Life Sciences & Biomedicine</subject><subject>Maintenance Chemotherapy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Monoclonal antibodies</subject><subject>Patients</subject><subject>Pharmacology & Pharmacy</subject><subject>Remission</subject><subject>Remission Induction</subject><subject>Retrospective Studies</subject><subject>Science & Technology</subject><subject>Treatment Outcome</subject><subject>Ustekinumab - administration & dosage</subject><issn>0269-2813</issn><issn>1365-2036</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>AOWDO</sourceid><sourceid>EIF</sourceid><recordid>eNqNkc9u1DAQxiMEokvhwAsgS1yo0LZjO3-PVdQCUiU4lHPkOGOtS2KHjNNqb30Ern29PgnezdIDEhK-2Jr5zadv_CXJWw6nPJ4zNYZTnhVl-ixZcZlnawEyf56sQOTVWpRcHiWviG4AIC9AvEyOpEi54DJdJQ8XxqAO9hYdEjFv2EwBf1g3D6plnSdkSFr1KljvmHWsnvzGPd4_EOssoYr9MfbQBWJ3NmwiQrMxVu9KbEIavYtM8IyCcp2ausf7X3tZmls9xxr6mdigrAvolNOR3eCkxu3r5IVRPeGbw32cfL-8uK4_r6--fvpSn1-ttSzLdN0aIzlkRlaCcwOm1QZ0q-Ouqqt4kbYCVNGZqjWgDMcOdV6CrACBK65ByOPkw6I7Tv7njBSawZLGvl-sNSKFFDJIsyKi7_9Cb_w8ueguUpxXwIWQkTpZKD15oglNM052UNO24dDs8mpiXs0-r8i-OyjO7YDdE_knoAiUC3CHrTe0-1aNT1jcMpOiqAoRX8BrG_Y51X52IY5-_P_RSJ8daNvj9t-Wm_Nv14v33wFTxeA</recordid><startdate>202007</startdate><enddate>202007</enddate><creator>Kopylov, Uri</creator><creator>Hanzel, Jurij</creator><creator>Liefferinckx, Claire</creator><creator>De Marco, Davide</creator><creator>Imperatore, Nicola</creator><creator>Plevris, Nikolas</creator><creator>Baston‐Rey, Iria</creator><creator>Harris, Richard J.</creator><creator>Truyens, Marie</creator><creator>Domislovic, Viktor</creator><creator>Vavricka, Stephan</creator><creator>Biemans, Vince</creator><creator>Myers, Sally</creator><creator>Sebastian, Shaji</creator><creator>Ben‐Horin, Shomron</creator><creator>González Lama, Yago</creator><creator>Gilletta, Cyrielle</creator><creator>Ariella, Bar‐Gil Shitrit</creator><creator>Zelinkova, Zuzana</creator><creator>Weisshof, Roni</creator><creator>Storan, Darragh</creator><creator>Zittan, Eran</creator><creator>Farkas, Klaudia</creator><creator>Molnar, Tamas</creator><creator>Franchimont, Denis</creator><creator>Cremer, Anneline</creator><creator>Afif, Waqqas</creator><creator>Castiglione, Fabiana</creator><creator>Lees, Charles</creator><creator>Barreiro‐de Acosta, Manuel</creator><creator>Lobaton, Triana</creator><creator>Doherty, Glen</creator><creator>Krznaric, Zeljko</creator><creator>Pierik, Marieke</creator><creator>Hoentjen, Frank</creator><creator>Drobne, David</creator><general>Wiley</general><general>Wiley Subscription Services, Inc</general><scope>AOWDO</scope><scope>BLEPL</scope><scope>DTL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>M7N</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3670-6545</orcidid><orcidid>https://orcid.org/0000-0002-1361-8868</orcidid><orcidid>https://orcid.org/0000-0003-3230-6832</orcidid><orcidid>https://orcid.org/0000-0002-7156-0588</orcidid><orcidid>https://orcid.org/0000-0003-3378-4932</orcidid><orcidid>https://orcid.org/0000-0002-3229-8759</orcidid><orcidid>https://orcid.org/0000-0001-5314-4452</orcidid><orcidid>https://orcid.org/0000-0002-1264-4319</orcidid><orcidid>https://orcid.org/0000-0002-3715-5730</orcidid><orcidid>https://orcid.org/0000-0003-3158-8014</orcidid><orcidid>https://orcid.org/0000-0003-1817-7704</orcidid><orcidid>https://orcid.org/0000-0003-4384-5049</orcidid></search><sort><creationdate>202007</creationdate><title>Effectiveness of ustekinumab dose escalation in Crohn’s disease patients with insufficient response to standard‐dose subcutaneous maintenance therapy</title><author>Kopylov, Uri ; Hanzel, Jurij ; Liefferinckx, Claire ; De Marco, Davide ; Imperatore, Nicola ; Plevris, Nikolas ; Baston‐Rey, Iria ; Harris, Richard J. ; Truyens, Marie ; Domislovic, Viktor ; Vavricka, Stephan ; Biemans, Vince ; Myers, Sally ; Sebastian, Shaji ; Ben‐Horin, Shomron ; González Lama, Yago ; Gilletta, Cyrielle ; Ariella, Bar‐Gil Shitrit ; Zelinkova, Zuzana ; Weisshof, Roni ; Storan, Darragh ; Zittan, Eran ; Farkas, Klaudia ; Molnar, Tamas ; Franchimont, Denis ; Cremer, Anneline ; Afif, Waqqas ; Castiglione, Fabiana ; Lees, Charles ; Barreiro‐de Acosta, Manuel ; Lobaton, Triana ; Doherty, Glen ; Krznaric, Zeljko ; Pierik, Marieke ; Hoentjen, Frank ; Drobne, David</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3884-bff3105f39211f0fbcf0cbc000ad9174b20a7df9bf0af1edec680390e01a1c023</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Administration, Intravenous</topic><topic>Adult</topic><topic>Corticosteroids</topic><topic>Crohn Disease - drug therapy</topic><topic>Crohn's disease</topic><topic>Crohns disease</topic><topic>Dosage</topic><topic>Drug dosages</topic><topic>Female</topic><topic>Gastroenterology & Hepatology</topic><topic>Gastrointestinal Agents - administration & dosage</topic><topic>Humans</topic><topic>Immunotherapy</topic><topic>Injections, Subcutaneous</topic><topic>Intravenous administration</topic><topic>Life Sciences & Biomedicine</topic><topic>Maintenance Chemotherapy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Monoclonal antibodies</topic><topic>Patients</topic><topic>Pharmacology & Pharmacy</topic><topic>Remission</topic><topic>Remission Induction</topic><topic>Retrospective Studies</topic><topic>Science & Technology</topic><topic>Treatment Outcome</topic><topic>Ustekinumab - administration & dosage</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kopylov, Uri</creatorcontrib><creatorcontrib>Hanzel, Jurij</creatorcontrib><creatorcontrib>Liefferinckx, Claire</creatorcontrib><creatorcontrib>De Marco, Davide</creatorcontrib><creatorcontrib>Imperatore, Nicola</creatorcontrib><creatorcontrib>Plevris, Nikolas</creatorcontrib><creatorcontrib>Baston‐Rey, Iria</creatorcontrib><creatorcontrib>Harris, Richard J.</creatorcontrib><creatorcontrib>Truyens, Marie</creatorcontrib><creatorcontrib>Domislovic, Viktor</creatorcontrib><creatorcontrib>Vavricka, Stephan</creatorcontrib><creatorcontrib>Biemans, Vince</creatorcontrib><creatorcontrib>Myers, Sally</creatorcontrib><creatorcontrib>Sebastian, Shaji</creatorcontrib><creatorcontrib>Ben‐Horin, Shomron</creatorcontrib><creatorcontrib>González Lama, Yago</creatorcontrib><creatorcontrib>Gilletta, Cyrielle</creatorcontrib><creatorcontrib>Ariella, Bar‐Gil Shitrit</creatorcontrib><creatorcontrib>Zelinkova, Zuzana</creatorcontrib><creatorcontrib>Weisshof, Roni</creatorcontrib><creatorcontrib>Storan, Darragh</creatorcontrib><creatorcontrib>Zittan, Eran</creatorcontrib><creatorcontrib>Farkas, Klaudia</creatorcontrib><creatorcontrib>Molnar, Tamas</creatorcontrib><creatorcontrib>Franchimont, Denis</creatorcontrib><creatorcontrib>Cremer, Anneline</creatorcontrib><creatorcontrib>Afif, Waqqas</creatorcontrib><creatorcontrib>Castiglione, Fabiana</creatorcontrib><creatorcontrib>Lees, Charles</creatorcontrib><creatorcontrib>Barreiro‐de Acosta, Manuel</creatorcontrib><creatorcontrib>Lobaton, Triana</creatorcontrib><creatorcontrib>Doherty, Glen</creatorcontrib><creatorcontrib>Krznaric, Zeljko</creatorcontrib><creatorcontrib>Pierik, Marieke</creatorcontrib><creatorcontrib>Hoentjen, Frank</creatorcontrib><creatorcontrib>Drobne, David</creatorcontrib><collection>Web of Science - Science Citation Index Expanded - 2020</collection><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>MEDLINE - Academic</collection><jtitle>Alimentary pharmacology & therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kopylov, Uri</au><au>Hanzel, Jurij</au><au>Liefferinckx, Claire</au><au>De Marco, Davide</au><au>Imperatore, Nicola</au><au>Plevris, Nikolas</au><au>Baston‐Rey, Iria</au><au>Harris, Richard J.</au><au>Truyens, Marie</au><au>Domislovic, Viktor</au><au>Vavricka, Stephan</au><au>Biemans, Vince</au><au>Myers, Sally</au><au>Sebastian, Shaji</au><au>Ben‐Horin, Shomron</au><au>González Lama, Yago</au><au>Gilletta, Cyrielle</au><au>Ariella, Bar‐Gil Shitrit</au><au>Zelinkova, Zuzana</au><au>Weisshof, Roni</au><au>Storan, Darragh</au><au>Zittan, Eran</au><au>Farkas, Klaudia</au><au>Molnar, Tamas</au><au>Franchimont, Denis</au><au>Cremer, Anneline</au><au>Afif, Waqqas</au><au>Castiglione, Fabiana</au><au>Lees, Charles</au><au>Barreiro‐de Acosta, Manuel</au><au>Lobaton, Triana</au><au>Doherty, Glen</au><au>Krznaric, Zeljko</au><au>Pierik, Marieke</au><au>Hoentjen, Frank</au><au>Drobne, David</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effectiveness of ustekinumab dose escalation in Crohn’s disease patients with insufficient response to standard‐dose subcutaneous maintenance therapy</atitle><jtitle>Alimentary pharmacology & therapeutics</jtitle><stitle>ALIMENT PHARM THER</stitle><addtitle>Aliment Pharmacol Ther</addtitle><date>2020-07</date><risdate>2020</risdate><volume>52</volume><issue>1</issue><spage>135</spage><epage>142</epage><pages>135-142</pages><issn>0269-2813</issn><eissn>1365-2036</eissn><abstract>Summary
Background
Ustekinumab is effective in Crohn's disease. However, a substantial proportion of patients will not respond or lose response to ustekinumab. The current evidence to support the effectiveness of dose‐optimisation for ustekinumab nonresponse is limited.
Aim
To assess the effectiveness of dose escalation of ustekinumab.
Methods
This was a multicentre retrospective cohort study. We included active Crohn's disease patients who received a standard‐dose intravenous induction and at least one subcutaneous ustekinumab 90 mg dose. All enrolled patients received dose escalation by either shortening the interval between the doses to every 4 or 6 weeks, intravenous reinduction or a combination of strategies. The primary outcome of the study was clinical response at week 16 after dose escalation.
Results
A total of 142 patients (22 centres/14 countries) were included. The patients were dose‐escalated after a median treatment duration of 30 weeks. At week 16 from escalation, 73/142 (51.4%) responded to treatment, including 55/142 (38.7%) in clinical remission. Corticosteroid‐free remission was achieved in 6/34 (17.6%) patients on corticosteroids at the time of escalation; 118/142 (83%) continued treatment beyond week 16. Follow‐up data beyond week 16 were available for 74/118 (62.7%) patients. On the last follow‐up, 51/98 (52%) patients with available data responded to treatment, including 41/98 (42%) in clinical remission.
Conclusions
Intensification of ustekinumab maintenance dosage was effective in over 50% of the patients. This strategy should be considered in patients who are nonresponsive to every 8 weeks ustekinumab maintenance dosing.</abstract><cop>HOBOKEN</cop><pub>Wiley</pub><pmid>32412134</pmid><doi>10.1111/apt.15784</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-3670-6545</orcidid><orcidid>https://orcid.org/0000-0002-1361-8868</orcidid><orcidid>https://orcid.org/0000-0003-3230-6832</orcidid><orcidid>https://orcid.org/0000-0002-7156-0588</orcidid><orcidid>https://orcid.org/0000-0003-3378-4932</orcidid><orcidid>https://orcid.org/0000-0002-3229-8759</orcidid><orcidid>https://orcid.org/0000-0001-5314-4452</orcidid><orcidid>https://orcid.org/0000-0002-1264-4319</orcidid><orcidid>https://orcid.org/0000-0002-3715-5730</orcidid><orcidid>https://orcid.org/0000-0003-3158-8014</orcidid><orcidid>https://orcid.org/0000-0003-1817-7704</orcidid><orcidid>https://orcid.org/0000-0003-4384-5049</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0269-2813 |
| ispartof | Alimentary pharmacology & therapeutics, 2020-07, Vol.52 (1), p.135-142 |
| issn | 0269-2813 1365-2036 |
| language | eng |
| recordid | cdi_webofscience_primary_000532797200001CitationCount |
| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Access via Wiley Online Library; Web of Science - Science Citation Index Expanded - 2020<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" />; Wiley Online Library (Open Access Collection) |
| subjects | Administration, Intravenous Adult Corticosteroids Crohn Disease - drug therapy Crohn's disease Crohns disease Dosage Drug dosages Female Gastroenterology & Hepatology Gastrointestinal Agents - administration & dosage Humans Immunotherapy Injections, Subcutaneous Intravenous administration Life Sciences & Biomedicine Maintenance Chemotherapy Male Middle Aged Monoclonal antibodies Patients Pharmacology & Pharmacy Remission Remission Induction Retrospective Studies Science & Technology Treatment Outcome Ustekinumab - administration & dosage |
| title | Effectiveness of ustekinumab dose escalation in Crohn’s disease patients with insufficient response to standard‐dose subcutaneous maintenance therapy |
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