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Ustekinumab Is Associated with Real-World Long-Term Effectiveness and Improved Health-Related Quality of Life in Crohn's Disease
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Department of Biomedical and Clinical Sciences, Division of Surgery, Linköping University Hospital, Linköping University, Linköping, Sweden.
Department of Internal Medicine, Södra Älvsborg Hospital, Borås, Sweden.
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2023 (English)In: Digestive Diseases and Sciences, ISSN 0163-2116, E-ISSN 1573-2568, Vol. 68, no 1, p. 65-76Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Prospectively and systematically collected long-term real-world clinical data on ustekinumab (anti-interleukin-12/23) are still scarce.

AIMS: To assess the long-term effectiveness of ustekinumab in patients with active Crohn's disease (CD).

METHODS: This is a prospective multicenter study of adult patients with CD initiating ustekinumab according to recommended doses at 20 Swedish hospitals. The primary outcome was clinical remission (Harvey-Bradshaw Index (HBI) ≤ 4 points) at weeks 52 and 104. Secondary outcomes included clinical response (≥ 3-point-decrease in HBI among patients with initial HBI ≥ 5 points), treatment retention, and biomarkers (C-reactive protein (CRP), hemoglobin, fecal-calprotectin) at weeks 52 and 104 compared to baseline. We also reported Health-related Quality of Life (HRQoL) measures.

RESULTS: Of 114 included patients, 107 (94%) had previously failed ≥ 1 and 58 (51%) ≥ 2 anti-tumor necrosis factor agents. Forty (35%) had failed anti-integrin agents. Ustekinumab retention rates at weeks 52 and 104 were 70% (n = 80/114) and 61% (n = 69/114), respectively. Clinical response was seen in 36% (n = 25/69) and 29% (n = 20/69) of the patients, and remission was achieved in 32% (n = 31/96) and 29% (n = 28/96) at weeks 52 and 104, respectively. Median HBI and CRP levels decreased significantly at both timepoints as compared to baseline. Significant improvements were also observed in HRQoL. Adverse events were reported in 11% (n = 13/114) of the patients, including five cases of severe adverse events. No malignancies were observed.

CONCLUSIONS: In this nationwide prospective real-world 104-week-follow-up study of adult patients with active CD, ustekinumab was associated with long-term clinical effectiveness and improvement in HRQoL measures when used in routine clinical care.

Place, publisher, year, edition, pages
Kluwer Academic Publishers, 2023. Vol. 68, no 1, p. 65-76
Keywords [en]
Crohn’s disease, Inflammatory bowel disease, Observational study, Ustekinumab
National Category
Gastroenterology and Hepatology
Identifiers
URN: urn:nbn:se:oru:diva-98796DOI: 10.1007/s10620-022-07501-zISI: 000786115100002PubMedID: 35459973Scopus ID: 2-s2.0-85134158040OAI: oai:DiVA.org:oru-98796DiVA, id: diva2:1655873
Funder
The Karolinska Institutet's Research Foundation
Note

Funding agency:

Janssen Cilag AB, Sweden

Available from: 2022-05-04 Created: 2022-05-04 Last updated: 2023-12-08Bibliographically approved

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Halfvarson, JonasLudvigsson, Jonas F.

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