Effectiveness and Safety of Ustekinumab in Ulcerative Colitis: Real-world Evidence from the ENEIDA Registry.


Journal

Journal of Crohn's & colitis
ISSN: 1876-4479
Titre abrégé: J Crohns Colitis
Pays: England
ID NLM: 101318676

Informations de publication

Date de publication:
08 Nov 2021
Historique:
pubmed: 17 4 2021
medline: 11 11 2021
entrez: 16 4 2021
Statut: ppublish

Résumé

The development programm UNIFI has shown promising results of ustekinumab in ulcerative colitis [UC] treatment which should be confirmed in clinical practice. We aimed to evaluate the durability, effectiveness, and safety of ustekinumab in UC in real life. Patients included in the prospectively maintained ENEIDA registry, who received at least one intravenous dose of ustekinumab due to active UC [Partial Mayo Score [PMS]>2], were included. Clinical activity and effectiveness were defined based on PMS. Short-term response was assessed at Week 16. A total of 95 patients were included. At Week 16, 53% of patients had response [including 35% of patients in remission]. In the multivariate analysis, elevated serum C-reactive protein was the only variable significantly associated with lower likelihood of achieving remission. Remission was achieved in 39% and 33% of patients at Weeks 24 and 52, respectively; 36% of patients discontinued the treatment with ustekinumab during a median follow-up of 31 weeks. The probability of maintaining ustekinumab treatment was 87% at Week 16, 63% at Week 56, and 59% at Week 72; primary failure was the main reason for ustekinumab discontinuation. No variable was associated with risk of discontinuation. Three patients reported adverse events; one of them had a fatal severe SARS-CoV-2 infection. Ustekinumab is effective in both the short and the long term in real life, even in a highly refractory cohort. Higher inflammatory burden at baseline correlated with lower probability of achieving remission. Safety was consistent with the known profile of ustekinumab.

Sections du résumé

BACKGROUND AND AIMS OBJECTIVE
The development programm UNIFI has shown promising results of ustekinumab in ulcerative colitis [UC] treatment which should be confirmed in clinical practice. We aimed to evaluate the durability, effectiveness, and safety of ustekinumab in UC in real life.
METHODS METHODS
Patients included in the prospectively maintained ENEIDA registry, who received at least one intravenous dose of ustekinumab due to active UC [Partial Mayo Score [PMS]>2], were included. Clinical activity and effectiveness were defined based on PMS. Short-term response was assessed at Week 16.
RESULTS RESULTS
A total of 95 patients were included. At Week 16, 53% of patients had response [including 35% of patients in remission]. In the multivariate analysis, elevated serum C-reactive protein was the only variable significantly associated with lower likelihood of achieving remission. Remission was achieved in 39% and 33% of patients at Weeks 24 and 52, respectively; 36% of patients discontinued the treatment with ustekinumab during a median follow-up of 31 weeks. The probability of maintaining ustekinumab treatment was 87% at Week 16, 63% at Week 56, and 59% at Week 72; primary failure was the main reason for ustekinumab discontinuation. No variable was associated with risk of discontinuation. Three patients reported adverse events; one of them had a fatal severe SARS-CoV-2 infection.
CONCLUSIONS CONCLUSIONS
Ustekinumab is effective in both the short and the long term in real life, even in a highly refractory cohort. Higher inflammatory burden at baseline correlated with lower probability of achieving remission. Safety was consistent with the known profile of ustekinumab.

Identifiants

pubmed: 33860795
pii: 6228235
doi: 10.1093/ecco-jcc/jjab070
pmc: PMC8083263
doi:

Substances chimiques

Ustekinumab FU77B4U5Z0

Types de publication

Journal Article Multicenter Study Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

1846-1851

Subventions

Organisme : Biogen
Organisme : Takeda Foundation
Organisme : Pfizer

Informations de copyright

© The Author(s) 2021. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Auteurs

María Chaparro (M)

Gastroenterology Department of Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa [IIS-IP], Universidad Autónoma de Madrid, and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas [CIBERehd], Madrid. Spain.

Ana Garre (A)

Gastroenterology Department of Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa [IIS-IP], Universidad Autónoma de Madrid, and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas [CIBERehd], Madrid. Spain.

Marisa Iborra (M)

Gastroenterology Department of Hospital Universitario y Politécnico La Fe and CIBERehd, Valencia, Spain.

Mónica Sierra-Ausín (M)

Gastroenterology Department of Hospital Universitario de León, Gerencia regional de salud de Castilla y León, León, Spain.

Manuel Barreiro-de Acosta (M)

Gastroenterology Department of Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain.

Agnès Fernández-Clotet (A)

Gastroenterology Department of Hospital Clìnic i Provincial and CIBERehd, IDIBAPS, Barcelona, Spain.

Luisa de Castro (L)

Gastroenterology Department of Xerencia Xestion Integrada de Vigo, Research Group in Digestive Diseases, Galicia Sur Health Research Institute, SERGAS-UVIGO, Spain.

Maia Boscá-Watts (M)

Gastroenterology Department of Hospital Clinico de Valencia. Universitat de València, Valencia, Spain.

María José Casanova (MJ)

Gastroenterology Department of Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa [IIS-IP], Universidad Autónoma de Madrid, and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas [CIBERehd], Madrid. Spain.

Alicia López-García (A)

Gastroenterology Department of Hospital del Mar and Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.

Rufo Lorente (R)

Gastroenterology Department of Hospital Clínico Universitario Lozano Blesa, IIS Aragón and CIBERehd, Zaragoza, Spain.

Cristina Rodríguez (C)

Gastroenterology Department of Complejo Hospitalario de Navarra, Navarra, Spain.

Ana Y Carbajo (AY)

Gastroenterology Department of Hospital Universitario Río Hortega. Gerencia Regional de Salud de Castilla y León [SACYL], Valladolid, Spain.

Maria Teresa Arroyo (MT)

Gastroenterology Department of HCU Lozano Blesa, IIS Aragón and CIBERehd, Zaragoza, Spain.

Ana Gutiérrez (A)

Gastroenterology Department of Hospital General Universitario de Alicante and CIBERehd, IIS ISABIAL Alicante, Spain.

Joaquín Hinojosa (J)

Gastroenterology Department of Hospital de Manises, Valencia, Spain.

Teresa Martínez-Pérez (T)

Gastroenterology Department of Hospital Virgen de la Luz, Cuenca, Spain.

Albert Villoria (A)

Gastroenterology Department of Hospital Parc Taulí, Sabadell, Departament de Medicina, Universitat Autònoma de Barcelona and CIBERehd, Spain.

Fernando Bermejo (F)

Gastroenterology Department of Hospital Universitario Fuenlabrada and Instituto de Investigación Sanitaria del Hospital La Paz [IdiPAZ], Madrid, Spain.

David Busquets (D)

Gastroenterology Department of Hospital Universitario de Girona Dr. Josep Trueta, Girona, Spain.

Blau Camps (B)

Gastroenterology Department of Hospital Universitario de Bellvitge, Barcelona, Spain.

Fiorella Cañete (F)

Gastroenterology Department of Hospital Universitari Germans Trials i Pujol and CIBERehd, Badalona, Spain.

Noemí Manceñido (N)

Gastroenterology Department of Hospital Infanta Sofía, San Sebastián de los Reyes, Spain.

David Monfort (D)

Gastroenterology Department of Consorci Sanitari de Terrassa, Terrassa, Spain.

Mercè Navarro-Llavat (M)

Gastroenterology Department of Hospital de Sant Joan Despí Moisès Broggi, Barcelona, Spain.

José Lázaro Pérez-Calle (JL)

Gastroenterology Department of Hospital Universitario Fundación Alcorcón, Madrid, Spain.

Laura Ramos (L)

Gastroenterology Department of Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain.

Montserrat Rivero (M)

Gastroenterology Department of Hospital Universitario Marqués de Valdecilla and IDIVAL, Santander, Spain.

Teresa Angueira (T)

Gastroenterology Department of Hospital General de Tomelloso and CIBERehd, Ciudad Real, Spain.

Patricia Camo Monterde (P)

Gastroenterology Department of Hospital General San Jorge, Huesca, Spain.

Daniel Carpio (D)

Gastroenterology Department of Complexo Hospitalario Universitario de Pontevedra, Pontevedra, Spain.

Irene García-de-la-Filia (I)

Gastroenterology Department of Hospital Universitario Ramon y Cajal, Madrid, Spain.

Carlos González-Muñoza (C)

Gastroenterology Department of Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

Luis Hernández (L)

Gastroenterology Department of Hospital Santos Reyes, Burgos, Spain.

José M Huguet (JM)

Gastroenterology Department of Hospital General Universitario de Valencia, Valencia, Spain.

Víctor J Morales (VJ)

Gastroenterology Department of Hospital General de Granollers, Barcelona, Spain.

Beatriz Sicilia (B)

Gastroenterology Department of Hospital Universitario de Burgos, Burgos, Spain.

Pablo Vega (P)

Gastroenterology Department of Complejo Hospitalario Universitario de Ourense, Ourense, Spain.

Isabel Vera (I)

Gastroenterology Department of Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.

Yamile Zabana (Y)

Gastroenterology Department of Hospital Universitari Mútua Terrassa and CIBERehd, Terrassa, Spain.

Pilar Nos (P)

Gastroenterology Department of Hospital Universitario y Politécnico La Fe and CIBERehd, Valencia, Spain.

Patricia Suárez Álvarez (P)

Gastroenterology Department of Hospital Universitario de León, Gerencia regional de salud de Castilla y León, León, Spain.

Cristina Calviño-Suárez (C)

Gastroenterology Department of Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain.

Elena Ricart (E)

Gastroenterology Department of Hospital Clìnic i Provincial and CIBERehd, IDIBAPS, Barcelona, Spain.

Vicent Hernández (V)

Gastroenterology Department of Xerencia Xestion Integrada de Vigo, Research Group in Digestive Diseases, Galicia Sur Health Research Institute, SERGAS-UVIGO, Spain.

Miguel Mínguez (M)

Gastroenterology Department of Hospital Clinico de Valencia. Universitat de València, Valencia, Spain.

Lucía Márquez (L)

Gastroenterology Department of Hospital del Mar and Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.

Daniel Hervías Cruz (D)

Gastroenterology Department of Hospital Clínico Universitario Lozano Blesa, IIS Aragón and CIBERehd, Zaragoza, Spain.

Saioa Rubio Iturria (S)

Gastroenterology Department of Complejo Hospitalario de Navarra, Navarra, Spain.

Jesús Barrio (J)

Gastroenterology Department of Hospital Universitario Río Hortega. Gerencia Regional de Salud de Castilla y León [SACYL], Valladolid, Spain.

Carla Gargallo-Puyuelo (C)

Gastroenterology Department of HCU Lozano Blesa, IIS Aragón and CIBERehd, Zaragoza, Spain.

Rubén Francés (R)

Gastroenterology Department of Hepatic and Intestinal Immunobiology Group, Department of Clinical Medicine, Miguel Hernández University, IIS Isabial-Hospital General Universitario de Alicante and CIBERehd, Alicante, Spain.

Esther Hinojosa (E)

Gastroenterology Department of Hospital de Manises, Valencia, Spain.

María Del Moral (M)

Gastroenterology Department of Hospital Virgen de la Luz, Cuenca, Spain.

Xavier Calvet (X)

Gastroenterology Department of Hospital Parc Taulí, Sabadell, Departament de Medicina, Universitat Autònoma de Barcelona and CIBERehd, Spain.

Alicia Algaba (A)

Gastroenterology Department of Hospital Universitario Fuenlabrada and Instituto de Investigación Sanitaria del Hospital La Paz [IdiPAZ], Madrid, Spain.

Xavier Aldeguer (X)

Gastroenterology Department of Hospital Universitario de Girona Dr. Josep Trueta, Girona, Spain.

Jordi Guardiola (J)

Gastroenterology Department of Hospital Universitario de Bellvitge, Barcelona, Spain.

Miriam Mañosa (M)

Gastroenterology Department of Hospital Universitari Germans Trials i Pujol and CIBERehd, Badalona, Spain.

Ramón Pajares (R)

Gastroenterology Department of Hospital Infanta Sofía, San Sebastián de los Reyes, Spain.

Marta Piqueras (M)

Gastroenterology Department of Consorci Sanitari de Terrassa, Terrassa, Spain.

Orlando García-Bosch (O)

Gastroenterology Department of Hospital de Sant Joan Despí Moisès Broggi, Barcelona, Spain.

Pilar López Serrano (P)

Gastroenterology Department of Hospital Universitario Fundación Alcorcón, Madrid, Spain.

Beatriz Castro (B)

Gastroenterology Department of Hospital Universitario Marqués de Valdecilla and IDIVAL, Santander, Spain.

Alfredo J Lucendo (AJ)

Gastroenterology Department of Hospital General de Tomelloso and CIBERehd, Ciudad Real, Spain.

Miguel Montoro (M)

Gastroenterology Department of Hospital General San Jorge, Huesca, Spain.

Elena Castro Ortiz (E)

Gastroenterology Department of Complexo Hospitalario Universitario de Pontevedra, Pontevedra, Spain.

Francisco Mesonero (F)

Gastroenterology Department of Hospital Universitario Ramon y Cajal, Madrid, Spain.

Esther García-Planella (E)

Gastroenterology Department of Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

David A Fuentes (DA)

Gastroenterology Department of Hospital Santos Reyes, Burgos, Spain.

Inmaculada Bort (I)

Gastroenterology Department of Hospital General Universitario de Valencia, Valencia, Spain.

Pedro Delgado-Guillena (P)

Gastroenterology Department of Hospital General de Granollers, Barcelona, Spain.

Lara Arias (L)

Gastroenterology Department of Hospital Universitario de Burgos, Burgos, Spain.

Agueda Iglesias (A)

Gastroenterology Department of Complejo Hospitalario Universitario de Ourense, Ourense, Spain.

Marta Calvo (M)

Gastroenterology Department of Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.

Maria Esteve (M)

Gastroenterology Department of Hospital Universitari Mútua Terrassa and CIBERehd, Terrassa, Spain.

Eugeni Domènech (E)

Gastroenterology Department of Hospital Universitari Germans Trials i Pujol and CIBERehd, Badalona, Spain.

Javier P Gisbert (JP)

Gastroenterology Department of Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa [IIS-IP], Universidad Autónoma de Madrid, and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas [CIBERehd], Madrid. Spain.

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