PTH-085 Ustekinumab for refractory Crohn’s disease (CD) in adolescents: experience from two UK IBD centres
Year: 2019
Type: conference-abstract
Abstract: Introduction The incidence of CD in adolescents and young persons (AYP) is increasing. Whilst antiTNF use in AYP is well established, little is known about the efficacy and safety of ustekinumab. We report our multicentre experience. Methods Data was retrospectively collected on 14–23yr olds starting ustekinumab at University College London Hospital (UCLH) and The Royal London Hospital (RLH) from September 2017–18. Endpoints were: clinical (i) response (reduction in Harvey Bradshaw Index (HBI) of ≥3 or sustained HBI ≤4 points) and (ii) remission (HBI ≤4 points) and biological (i) response (50% reduction in CRP) and (ii) remission (CRP <5 mg/L where baseline CRP >5 mg/L) after 1st, 2nd and 3rd doses. Results Table 1 summarises the baseline characteristics of 33 AYP commenced on ustekinumab. All patients received i.v. drug at baseline, s.c. second dose at week 8, and 8–12 weekly s.c. doses thereafter. Treatment was stopped in 5 patients prior to week 16 (one for drug reaction; three for primary non-response, two of whom required intestinal resection). Three patients experienced other adverse events (two related to perianal disease, one due to pain and vomiting) but did not discontinue treatment. After the 1st, 2nd, and 3rd doses, clinical rates of (i) response and (ii) remission were (i) 40, 38 and 43% and (ii) 50, 36 and 29% respectively. After the 1st, 2nd and 3rd doses, biological rates of (i) response and (ii) remission were (i) 24, 27, 33% and (ii) 10, 19, 11% respectively. Conclusions We report on the use of ustekinumab in AYP at 2 tertiary IBD centres. Baseline characteristics reflect early onset CD in antiTNF experienced patients with a high proportion of upper GI involvement and previous instestinal resection. Ustekinumab is efficacious in this cohort, with early clinical endpoints comparable to trial and real-world literature seen in older populations.
Source: Gut
Authors: Radha Gadhok, Rohit Rao, Louis Harpham-Lockyer, Hanson Kwok, Lisa Whitley, Ana Ibarra, Natasha Burgess, Sara McCartney, Klaartje Kok
Institutions: Royal London Hospital, University College Hospital
Language: English
Topic: Inflammatory Bowel Disease
Subfield: Gastroenterology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4245222136