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P462 Efficacy of ustekinumab for the prevention of postoperative recurrence in crohn’s disease. Data from clinical practice from the eneida registry

Year: 2020
Type: conference-abstract
Abstract: Background Anti-TNF and thiopurines are the only drugs that demonstrated efficacy in preventing postoperative recurrence (POR) in Crohn’s disease (CD). However, in some cases these drugs are contraindicated or have previously failed. Recently, ustekinumab was licensed for CD but no data on its efficacy in the prevention of POR is still available. Methods All CD patients in whom ustekinumab was prescribed for primary prevention of POR within the first 3 months after ileocecal or ileocolonic resection with anastomosis were identified from the ENEIDA registry (a prospectively maintained database of the Spanish Working Group in IBD –GETECCU-). We evaluated the rates of endoscopic, clinical or surgical POR in the first 18 months. Endoscopic POR was defined by a Rutgeerts score >i1 and advanced endoscopic POR by >i2. Results Thirty patients were included; ustekinumab was started after a median time of 60 days (IIQ 31–90). Concomitant immunosuppressants were used in 17%, 27% received an additional 3-month course of metronidazole after surgery. Regarding risk factors for POR: 23% were active smokers, 62% had prior resections, 33% had penetrating CD behaviour, and 22% had a history of perianal disease. In total, 36% of them had more than one risk factor. 50% had been exposed to ustekinumab prior to the index surgery (46% within the last 6 months). The median time of follow-up on ustekinumab was 17 months (IQR 11–21). Fifty-six per cent of patients had at least one endoscopic assessment within 18 months after surgery: 58% had endoscopic POR and 23% advanced endoscopic POR. Additionally, 13% presented clinical POR at the discretion of the treating physician and none developed surgical POR. Conclusion In a small clinical practice cohort, ustekinumab showed similar efficacy as that reported with anti-TNF in the prevention of endoscopic POR. Unfortunately, the lack of early endoscopic monitoring is still frequent despite the recommendations from guidelines.
DOI: 10.1093/ecco-jcc/jjz203.591
Authors: M Mañosa Ciria, A Fernandez-Clotet, A Hernández-Camba, R Muñoz Pérez, M Iborra, M Sierra, L Márquez, P Delgado-Guillena, D Busquets, M Van Domselaar, E Girona, E Sánchez-Rodríguez, M D Martín-Arranz, R Lorente, D Casas-Deza, M Boscá, F Cañete, M Calafat, E Domènech
Institutions: Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Hospital Universitari Germans Trias i Pujol, Hospital Clínic de Barcelona, Hospital Universitario Nuestra Señora de Candelaria, Hospital General Universitario de Alicante Doctor Balmis, Hospital Universitari i Politècnic La Fe, Hospital Universitario de León, Hospital Del Mar, Hospital General de Granollers, Hospital Universitari de Girona Doctor Josep Trueta, Hospital Universitario de Torrejón, Hospital General Universitario de Elche, Hospital Universitario Ramón y Cajal, Hospital Universitario La Paz, Hospital General Universitario de Ciudad Real, Hospital Universitario Miguel Servet, Hospital Clínico Universitario de Valencia
Language: English
Field: Medicine
Open Access status: bronze
OpenAlex ID: W4240202007
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Cited by: 3
Related to: 10