{"id":7743,"date":"2020-04-14T09:54:22","date_gmt":"2020-04-14T07:54:22","guid":{"rendered":"https:\/\/www.endoscopy-campus.com\/?post_type=ec-news&p=7743"},"modified":"2020-04-14T09:54:23","modified_gmt":"2020-04-14T07:54:23","slug":"shortening-ustekinumab-interval-to-every-4-weeks-associated-with-increased-rates-of-clinical-and-biological-remission-in-patients-with-crohns-disease","status":"publish","type":"ec-news","link":"https:\/\/www.endoscopy-campus.com\/en\/ec-news\/shortening-ustekinumab-interval-to-every-4-weeks-associated-with-increased-rates-of-clinical-and-biological-remission-in-patients-with-crohns-disease\/","title":{"rendered":"Shortening Ustekinumab Interval to Every 4 Weeks Associated With Increased Rates of Clinical and Biological Remission in Patients With Crohn\u2019s Disease"},"content":{"rendered":"\n

Monika Fischer, MD, reviewing Ollech JE, et al. Clin Gastroenterol Hepatol 2020 Feb 25.<\/em><\/strong><\/em><\/p>\n\n\n\n

This single-center retrospective study evaluated the outcomes of 110 patients with Crohn\u2019s disease who underwent dose intensification, thus shortening the interval between 90-mg doses of ustekinumab from every 8 weeks to every 4 weeks. Clinicians at a tertiary-care center shortened the dosing interval of ustekinumab in patients with active Crohn\u2019s disease based upon clinical symptoms, elevated biologic markers, and\/or endoscopy. Serum trough concentrations of ustekinumab and anti-ustekinumab antibodies were not routinely measured and, therefore, were not taken into consideration in the analysis (according to personal communication with Dr. Pekow, one of the study authors). <\/p>\n\n\n\n

The median time to dose escalation was 7.5 months after therapy initiation (interquartile range [IQR], 4.2-13.2). Patients had clinically, biologically, and\/or endoscopically active disease based upon a Harvey Bradshaw Index (HBI) score >4, a C-reactive protein (CRP) level \u22655 mg\/dl, fecal calprotectin >250 ug\/g, or ulceration on ileocolonoscopy. After the dose interval was shortened, 28% of the patients achieved clinical remission (an HBI score \u22644), 22% had normalized CRP (<5 mg\/dl), 50% had reduced fecal calprotectin, and 36% achieved endoscopic remission at a median follow-up of 3 months (IQR, 1.7-5.4). Among patients on steroids at the time of dose escalation, 38% were weaned off steroids within 6 months. Among patients with perianal disease, 45% reported resolution of fistulas within 6 months. No serious adverse events were reported, and only one patient developed a rash during the intensified therapy.<\/p>\n\n\n\n

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COMMENT
This is the first paper to report real-world outcomes in patients with Crohn\u2019s disease after dose escalation of 90-mg ustekinumab to a shortened interval of 4 weeks. Notably, about one-third of patients not on clinical, biological, or endoscopic remission with the 8-week dosing interval achieved remission on the 4-week dosing interval approved by the FDA. Before stopping ustekinumab in primary and secondary nonresponders, it is worthwhile to try shortening the dosing interval:<\/p><\/blockquote><\/figure>\n\n\n\n

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Monika Fischer, MD, FASGE<\/p>\n<\/div><\/div>\n\n\n\n

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CITATION(S )<\/h2>\n\n\n\n

Ollech JE, Normatov I, Peleg N, et al. Effectiveness of ustekinumab dose escalation in patients with Crohn\u2019s disease.\u00a0Clin Gastroenterol Hepatol<\/em>\u00a02020 Feb 25. (Epub ahead of print) (https:\/\/doi.org\/10.1016\/j.cgh.2020.02.035<\/a>)<\/p>\n","protected":false},"excerpt":{"rendered":"

Monika Fischer, MD, reviewing Ollech JE, et al. Clin Gastroenterol Hepatol 2020 Feb 25. This single-center retrospective study evaluated the outcomes of 110 patients with Crohn\u2019s disease who underwent dose intensification, thus shortening the interval between 90-mg doses of ustekinumab from every 8 weeks to every 4 weeks. Clinicians at a tertiary-care center shortened the dosing … Read more<\/a><\/p>\n","protected":false},"template":"","categories":[1768,1790],"tags":[1870,543,1997],"class_list":["post-7743","ec-news","type-ec-news","status-publish","hentry","category-asge-journal-scan","category-ibd","tag-crohns-disease-2","tag-morbus-crohn","tag-ustekinumab-interval"],"_links":{"self":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/ec-news\/7743","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/ec-news"}],"about":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/types\/ec-news"}],"wp:attachment":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/media?parent=7743"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/categories?post=7743"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/tags?post=7743"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}