High serum levels of ustekinumab are associated with better clinical outcomes during maintenance treatment for inflammatory bowel disease

Autor: Jaime González-Antuña, Teresa Valdés-Delgado, Belén Maldonado-Pérez, María Belvis-Jiménez, Luisa Castro-Laria, Vicente Merino-Bohórquez, Miguel Ángel Calleja-Hernández, Paula Castro-Martínez, Cloe Charpentier, Federico Argüelles-Arias
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Therapeutic Advances in Gastroenterology, Vol 17 (2024)
Druh dokumentu: article
ISSN: 1756-2848
17562848
DOI: 10.1177/17562848241271980
Popis: Background: Ustekinumab (UST) is an effective treatment option in Crohn’s disease (CD) and ulcerative colitis (UC). However, it still remains unclear if therapeutic drug monitoring could be helpful to guide clinicians. Objectives: The aim of our study was to analyze the relationship between UST through levels (UST TL ) and clinical outcomes in real-world inflammatory bowel disease (IBD) patients. Design: We performed a unicentric retrospective study including patients with IBD under UST treatment with at least one level determination. Methods: The following variables were analyzed at the initiation of UST and at each UST TL measurement: clinical response and remission using the Harvey–Bradshaw Index (HBI) for CD and the Partial Mayo Score (pMayo) for UC; biochemical response and remission using fecal calprotectin and C-reactive protein, among others. Two periods were considered: P1 (time between induction and the first determination of UST TL ) and P2 (time between UST TL1 and the second determination of UST TL ). Results: We included 125 patients, 117 with CD. In P1, 62.4% of patients were on subcutaneous maintenance, and the median UST TL1 was 3.1 μg/mL (1.6–5.3). In 44.8% of CD patients (48/117), clinical remission was achieved, with UST TL1 significantly higher than those who did not achieve remission (3.7 μg/mL (2.3–5.4) vs 2.3 μg/mL (1.1–5.2); p = 0.04). In the 46 patients with two determinations, statistically significant differences were found between variables in P2 versus P1: clinical remission (73.9% vs 21.7%; p = 0.001); UST TL (7.2 μg/mL (4.7–11.7) vs 3.4 μg/mL (1.9–6.4); p
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