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Predictive factors of the clinical efficacy of ustekinumab in patients with refractory Crohn's disease: tertiary centers experience in Japan.
Esaki, Motohiro; Ihara, Yutaro; Tominaga, Naoyuki; Takedomi, Hironobu; Tsuruoka, Nanae; Akutagawa, Takashi; Yukimoto, Takahiro; Kawasaki, Keisuke; Umeno, Junji; Torisu, Takehiro; Sakata, Yasuhisa.
Afiliação
  • Esaki M; Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, 849-8501, Japan. mesaki01@cc.saga-u.ac.jp.
  • Ihara Y; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
  • Tominaga N; Department of Gastroenterology, Saga Medical Center Koseikan, Saga, Japan.
  • Takedomi H; Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, 849-8501, Japan.
  • Tsuruoka N; Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, 849-8501, Japan.
  • Akutagawa T; Department of Endoscopic Diagnostics and Therapeutics, Saga University Hospital, Saga, Japan.
  • Yukimoto T; Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, 849-8501, Japan.
  • Kawasaki K; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
  • Umeno J; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
  • Torisu T; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
  • Sakata Y; Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, 849-8501, Japan.
Int J Colorectal Dis ; 38(1): 57, 2023 Mar 01.
Article em En | MEDLINE | ID: mdl-36856849
ABSTRACT

PURPOSE:

Therapeutic efficacy of ustekinumab in the real-world data is limited in patients with refractory Crohn's disease (CD). In addition, factors predictive of better therapeutic efficacy of ustekinumab remains unsolved in CD. We aimed to evaluate therapeutic efficacy of ustekinumab in patients with refractory CD and to identify the factors associated with the efficacy of ustekinumab.

METHODS:

We retrospectively analyzed the clinical data of 72 patients treated with ustekinumab for refractory CD. Therapeutic efficacy was assessed at weeks 8, 26, 52, and 104 on the basis of dual remission, defined as the combination of Crohn's Disease Activity Index < 150 and CRP < 0.3 mg/dL, and factors predictive of the induction and maintenance of dual remission were investigated. The cumulative continuation rates and safety of ustekinumab were assessed.

RESULTS:

The dual remission rates at weeks 8, 26, 52, and 104 were 31.9%, 37.9%, 47.5%, and 42.6%, respectively. A short disease duration (≤ 2 years) and higher baseline serum albumin levels (≥ 3.1 g/dL) were positively associated with dual remission at weeks 8 and 52. Meanwhile, higher serum CRP levels (≥ 1.19 mg/dL) were negatively associated with dual remission at week 8. The cumulative ustekinumab continuation rate was favorable, and no severe adverse events were found.

CONCLUSION:

A short disease duration and higher baseline serum albumin levels might be predictive of favorable therapeutic efficacy of ustekinumab in refractory CD. Induction efficacy appears to be lower in patients with higher serum CRP levels.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Doença de Crohn / Ustekinumab Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans País como assunto: Asia Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Doença de Crohn / Ustekinumab Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans País como assunto: Asia Idioma: En Ano de publicação: 2023 Tipo de documento: Article