P-095 Experience with Ustekinumab in Mexican Patients with Moderate-Severe Anti-TNF Resistant Crohnʼs Disease
Jonathan Paz Delgadillo, Ricardo Flores Rendón, Maria Miranda Cordero, Francisco Bosques Padilla, Manuel Martínez Vazquez
Abstract
Jonathan Paz Delgadillo, Ricardo Flores Rendón, Maria Miranda Cordero, Francisco Bosques Padilla, Manuel Martínez Vazquez
Abstract
Ustekinumab is a fully human monoclonal IgGk antibody that blocks the p40 subunit shared by IL-12/23, inhibiting its binding to the receptor in T, NK and CPA cells 1. Multiple clinical trials have proved its efficacy in the treatment of psoriasis and for the induction and maintenance of remission in anti-TNF resistant Crohn's disease.1,2 Its effectiveness and experience in Latin American patients is nonexistent. In this study we report the experience of 3 centers that treated patients with moderate to severe anti-TNF-resistant Crohn's disease. Open, retrospective, observational study. Clinical response was evaluated by CDAI score at 3, 6, 12 months, and until last meeting, in addition to CRP levels. Seven patients were included in the study, 4 females and 3 males, mean age 49 ± 15, 4 patients had perianal involvement. The initial clinical response was reached at 3 months in 71.4% of patients (CDAI <150). At 6 months, 80% of patients with initial response maintained their response. At 12 months of follow-up, 60% of responders held initial response, in one of them treatment was suspended because of multiple episodes of sinusitis. At the time of the latest follow-up (10 ± 2.3 months) 57% of patients were in remission and 85% were able to discontinue steroids. In this cohort of Mexican patients with moderate to severe Crohn's disease resistant to anti-TNF, initial response was observed in 71.4% of patients. This response was maintained in most patients at 6 months. At 12 months 60% of the initial responders maintained their response. Ustekinumab is a therapeutic option in this group of patients highly difficult to control.
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Ustekinumab is a fully human monoclonal IgGk antibody that blocks the p40 subunit shared by IL-12/23, inhibiting its binding to the receptor in T, NK and CPA cells 1. Multiple clinical trials have proved its efficacy in the treatment of psoriasis and for the induction and maintenance of remission in anti-TNF resistant Crohn's disease.1,2 Its effectiveness and experience in Latin American patients is nonexistent. In this study we report the experience of 3 centers that treated patients with moderate to severe anti-TNF-resistant Crohn's disease. Open, retrospective, observational study. Clinical response was evaluated by CDAI score at 3, 6, 12 months, and until last meeting, in addition to CRP levels. Seven patients were included in the study, 4 females and 3 males, mean age 49 ± 15, 4 patients had perianal involvement. The initial clinical response was reached at 3 months in 71.4% of patients (CDAI <150). At 6 months, 80% of patients with initial response maintained their response. At 12 months of follow-up, 60% of responders held initial response, in one of them treatment was suspended because of multiple episodes of sinusitis. At the time of the latest follow-up (10 ± 2.3 months) 57% of patients were in remission and 85% were able to discontinue steroids. In this cohort of Mexican patients with moderate to severe Crohn's disease resistant to anti-TNF, initial response was observed in 71.4% of patients. This response was maintained in most patients at 6 months. At 12 months 60% of the initial responders maintained their response. Ustekinumab is a therapeutic option in this group of patients highly difficult to control.
Key concepts: Medicine, Ustekinumab, Crohn's disease, Internal medicine, Psoriasis, Gastroenterology, Retrospective cohort study, Disease