Journal
DIGESTIVE DISEASES AND SCIENCES
Volume 65, Issue 5, Pages 1445-1452Publisher
SPRINGER
DOI: 10.1007/s10620-019-05865-3
Keywords
Crohn's disease; Ustekinumab trough level; Antibodies to ustekinumab
Categories
Ask authors/readers for more resources
Introduction The aim of this study was to evaluate the association between serum ustekinumab (UST) trough levels and response to induction and maintenance UST treatment in refractory Crohn's Disease (CD) patients. Methods We performed a prospective study including CD patients who received UST from September 2015 to January 2017. Patients received 90 mg of UST subcutaneously at weeks 0, 4, and 12, then every 8 weeks. Two cohorts of patients were analyzed: an induction cohort and a maintenance cohort. We evaluated clinical, biological, and imaging/endoscopic response to UST treatment. UST trough levels and anti-UST antibodies were dosed at weeks 12 and 28 in the induction cohort, and at a single time point in the maintenance cohort. Results Forty-nine patients were enrolled in the maintenance cohort. Mean concentrations of UST were 1.88 +/- 1.40 mu g/mL. UST trough levels were not significantly different in patients with or without clinical, biological, or imaging/endoscopic responses to UST treatment (p > 0.11). Twenty-three consecutive patients were included in the induction cohort. At week 12, mean UST concentrations were 1.45 +/- 1.15 mu g/mL. Patients with a biological response to UST treatment had significant higher serum UST trough concentration (median 1.72 mu g/mL) than non-responders (median 0.56 mu g/mL, p = 0.02). A UST trough level >= 1.10 mu g/mL at week 12 was associated with a biological response to UST treatment at 6 months. Conclusion UST trough levels were associated with a biological response at the end of the induction phase. In patients with low levels of UST, optimization treatment may be necessary to obtain a sustained response.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available