Effectiveness of ustekinumab dose escalation in Crohn's disease patients with insufficient response to standard-dose subcutaneous maintenance therapy
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 o...
Elmentve itt :
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| Dokumentumtípus: | Cikk |
| Megjelent: |
2020
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| Sorozat: | ALIMENTARY PHARMACOLOGY & THERAPEUTICS
52 No. 1 |
| doi: | 10.1111/apt.15784 |
| mtmt: | 31507883 |
| Online Access: | http://publicatio.bibl.u-szeged.hu/19611 |
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| 024 | 7 | |a 31507883 |2 mtmt | |
| 040 | |a SZTE Publicatio Repozitórium |b hun | ||
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| 100 | 1 | |a Kopylov Uri | |
| 245 | 1 | 0 | |a Effectiveness of ustekinumab dose escalation in Crohn's disease patients with insufficient response to standard-dose subcutaneous maintenance therapy |h [elektronikus dokumentum] / |c Kopylov Uri |
| 260 | |c 2020 | ||
| 300 | |a 135-142 | ||
| 490 | 0 | |a ALIMENTARY PHARMACOLOGY & THERAPEUTICS |v 52 No. 1 | |
| 520 | 3 | |a 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. | |
| 700 | 0 | 1 | |a Hanzel Jurij |e aut |
| 700 | 0 | 1 | |a Liefferinckx Claire |e aut |
| 700 | 0 | 2 | |a Marco, de Davide |e aut |
| 700 | 0 | 2 | |a Imperatore Nicola |e aut |
| 700 | 0 | 2 | |a Plevris Nikolas |e aut |
| 700 | 0 | 2 | |a Baston-Rey Iria |e aut |
| 700 | 0 | 2 | |a Harris Richard J. |e aut |
| 700 | 0 | 2 | |a Truyens Marie |e aut |
| 700 | 0 | 2 | |a Domislovic Viktor |e aut |
| 700 | 0 | 2 | |a Vavricka Stephan |e aut |
| 700 | 0 | 2 | |a Biemans Vince |e aut |
| 700 | 0 | 2 | |a Myers Sally |e aut |
| 700 | 0 | 2 | |a Farkas Klaudia |e aut |
| 700 | 0 | 2 | |a Molnár Tamás |e aut |
| 856 | 4 | 0 | |u http://publicatio.bibl.u-szeged.hu/19611/1/31507883_Kopylov_apt.15784.pdf |z Dokumentum-elérés |