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Effectiveness of ustekinumab in patients with refractory Crohn's disease: a multicentre real-life study in Italy

Title: Effectiveness of ustekinumab in patients with refractory Crohn's disease: a multicentre real-life study in Italy
Authors: Maria Lia Scribano; Annalisa Aratari; Benedetto Neri; Cristina Bezzio; Paola Balestrieri; Valentina Baccolini; Giuliano Falasco; Caterina Camastra; Paolo Pantanella; Rita Monterubbianesi; Alessandro Tullio; Simone Saibeni; Claudio Papi; Livia Biancone; Rocco Cosintino; Roberto Faggiani
Contributors: Lia Scribano, Maria; Aratari, Annalisa; Neri, Benedetto; Bezzio, Cristina; Balestrieri, Paola; Baccolini, Valentina; Falasco, Giuliano; Camastra, Caterina; Pantanella, Paolo; Monterubbianesi, Rita; Tullio, Alessandro; Saibeni, Simone; Papi, Claudio; Biancone, Livia; Cosintino, Rocco; Faggiani, Roberto
Publication Year: 2022
Collection: Sapienza Università di Roma: CINECA IRIS
Subject Terms: crohn’s disease; effectivene; refractory; ustekinumab
Description: Background: The effectiveness of ustekinumab in patients with refractory Crohn’s disease (CD) has been investigated in several real-world studies. However, very few data concerning the real-life experience in Italy have been reported. Therefore, this study assessed the effectiveness of ustekinumab in a large cohort of Italian patients with refractory CD. Methods: All patients who had started on ustekinumab after failure of or intolerance to antitumour necrosis factor-a (TNF-a) treatment at five tertiary centres between November 2018 and February 2020 were retrospectively enrolled. The coprimary outcome was corticosteroid-free clinical remission, defined as a Harvey–Bradshaw Index (HBI) score of !4, at weeks 26 and 52. The secondary outcomes were changes in the HBI and C-reactive protein (CRP) values at weeks 8, 26, and 52 from baseline and the normalization of CRP in patients with initially abnormal values. Results: Totally, 140 patients who had previously received at least one anti-TNF- agent were enrolled; 40.0% received two anti-TNF- agents and 20.0% received vedolizumab. At baseline, 108 patients (77.1%) had HBI scores of >4; of these, 56.5% and 58.3% achieved corticosteroidfree clinical remission at weeks 26 and 52, respectively. Significant decreases in HBI and CRP values were observed at weeks 8, 26, and 52 in the entire study cohort (all p < 0.0001). The CRP values were normalized in 34.9%, 37.8%, and 49.3% of the patients by weeks 8, 26, and 52, respectively. The baseline HBI score of "8 was a negative predictor of corticosteroid-free clinical remission at week 52 (odds ratio: 0.21, 95% confidence interval: 0.08–0.56, p # 0.002). The probability of remaining on ustekinumab after 52 weeks was 92.1%. Eleven (7.9%) patients discontinued ustekinumab (three for adverse events). Conclusion: Our study findings confirm the effectiveness and safety of ustekinumab in patients with CD after failure of or intolerance to anti-TNF-a therapy.
Document Type: article in journal/newspaper
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/35186121; info:eu-repo/semantics/altIdentifier/wos/WOS:000759402200001; volume:15; firstpage:1; lastpage:13; numberofpages:13; journal:THERAPEUTIC ADVANCES IN GASTROENTEROLOGY; http://hdl.handle.net/11573/1616726
DOI: 10.1177/17562848211072412
Availability: http://hdl.handle.net/11573/1616726; https://doi.org/10.1177/17562848211072412
Rights: info:eu-repo/semantics/openAccess
Accession Number: edsbas.D2C48763
Database: BASE