Background and importance For the patient with moderate to severe Crohn’s disease, first-line options for induction therapy include a biologic agent. Tumour necrosis factor alpha antagonists (anti-TNFα) are recognised as the primary therapeutic option. Ustekinumab is an anti-IL 12/23 antibody that has been approved for use in patients who have had an inadequate response, show loss of response or are intolerant to conventional treatment or anti-TNFα or have contraindications.
Aim and objectives To describe the prescription of ustekinumab in real-life conditions in our hospital and to assess the appropriateness of ustekinumab prescription.
Material and methods All patients treated with ustekinumab were included during the period 2017–2021. Demographic variables: previous anti-TNFα agents used, dose or interval intensification, drug trough antidrug antibodies measurements, primary or secondary failure, concomitant medication, ustekinumab dose, and reason for switching (biomarkers, symptoms, mucosal inflammation) were collected. Data were obtained from the electronic medical record and prescription application. Appropriateness of prescription: therapeutic drug monitoring, intensification before switching, and contraindications to use of anti-TNFα.
Results The results are shown in Table 1.
Conclusion and relevance Given the high number of patients without therapeutic drug monitoring or with dose or interval intensification, it was decided to create an interdisciplinary commission made up of digestive and pharmaceutical experts in order to optimise drug prescribing in Crohn’s disease.
References and/or acknowledgements Overview of medical management of high-risk adult patients with moderate to severe Crohn’s disease up to date. https://www.uptodate.com/contents/overview-of-medical-management-of-high-risk-adult-patients-with-moderate-to-severe-crohn-disease
Conflict of interest No conflict of interest