Work

Repeated intravenous weight-based ustekinumab maintenance as an optimization strategy for Crohn’s disease patients with loss of response to standard therapy

Year: 2026

Type: article

Abstract: BACKGROUND: Some patients with Crohn's disease (CD) lose response to Ustekinumab (UST) standard therapy. Currently, there is limited evidence on efficacy of repeated intravenous (IV) weight-based UST maintenance in refractory CD . Here, we investigated the efficacy and safety of the optimization therapy in such patients. METHODS: In this retrospective study, 134 CD patients who had lost their response to UST were enrolled. Clinical response and remission were assessed at weeks 21 and 42 using the Harvey-Bradshaw Index, while secondary outcomes included biochemical and endoscopic measures. Safety was monitored throughout the study. RESULTS: At week 21, the clinical response and remission rates were 76.9% and 43.3%, respectively. These rates improved to 88.6% and 73.2% by week 42. Among the 75 patients who underwent endoscopic evaluation, 52.0% achieved endoscopic remission, and 76.0% demonstrated a response. Furthermore, the majority of patients (91.8%, 123/134) remained on the optimization regimen throughout week 42, and no significant adverse events were reported. CONCLUSION: Repeated IV weight-based UST maintenance has shown significant and sustained clinical, biochemical, and endoscopic improvements in most patients who have lost their response to standard UST therapy. This optimized regimen offers a promising therapeutic strategy for individuals who would otherwise need to switch to other biologics or dual-targeted therapies.

Source: Digestive and Liver Disease

DOI: 10.1016/j.dld.2026.04.019