Background and Importance In the context of loss of efficacy in patients treated with subcutaneous maintenance of ustekinumab (UST) for inflammatory bowel disease, Crohn’s disease (CD) and ulcerative colitis (UC), one of the strategies implemented has been re-induction or intensification.
Aim and Objectives To evaluate the effectiveness of re-induction or intensification with UST.
Material and Methods Retrospective observational study conducted in a tertiary hospital including patients treated with UST on subcutaneous maintenance every 8 weeks and who received a re-induction/intensification regimen between September 2019 and September 2022.
The following variables were collected sex, age, pathology, previous biological treatments (anti-TNFα [infliximab, adalimumab, certolizumab] or anti-α4β7 integrin [vedolizumab]), re-induction/intensification, analytical data (haemoglobin, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), faecal calprotectin) and clinical data (abdominal pain and daily stools).
The follow-up period was 6 weeks.
Results A total of 30 patients were included, with a median age of 40 years (17–73). Men represented 57%. A total of 77% were diagnosed with CD and 35% were diagnosed with UC. All patients with CD had been previously treated with one (13%) or more (87%) anti-TNFα drugs and 35% had received vedolizumab. All patients with UC also received treatment with one (29%) or two (71%) anti-TNFα drugs and 57% had received vedolizumab.
Out of 23 patients with CD, 11 received a re-induction and 12 intensified the regimen. Out of 7 patients with UC, 2 received a re-induction, 2 intensified the regimen and 3 received both. The re-induction consisted of an intravenous administration according to weight, except in 3 cases in which a fixed dose of 130 mg was administered. The intensification consisted of shortening the administration to every 4–6 weeks.
The percentages of patients who showed improvements in analytical measurements after the chosen strategy was administered are shown below.
Conclusion and Relevance Re-induction/intensification with UST is an effective option in the treatment of inflammatory bowel disease, in line with published clinical trials. The analytical data were better with re-induction. 77% of patients remain on the treatment.
References and/or Acknowledgements No conflict of interest
Conflict of Interest No conflict of interest
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