Ustekinumab Trough Concentrations Are Associated with Biochemical Outcomes in Patients with Crohn's Disease.


Journal

Digestive diseases and sciences
ISSN: 1573-2568
Titre abrégé: Dig Dis Sci
Pays: United States
ID NLM: 7902782

Informations de publication

Date de publication:
06 2023
Historique:
received: 25 07 2022
accepted: 01 01 2023
medline: 18 5 2023
pubmed: 16 3 2023
entrez: 15 3 2023
Statut: ppublish

Résumé

It is unknown whether ustekinumab (UST) levels can predict clinical outcomes in Crohn's disease (CD) patients. We assessed the exposure-response relationship of UST trough concentrations with biochemical outcomes at week 24 in a prospective, real-world setting. We performed a prospective study in patients with CD starting UST in four academic centres in the Netherlands. All patients received a weight-adjusted intravenous (IV) UST induction dose, followed by one subcutaneous (SC) dose of 90 mg UST at 8 weeks. Maintenance therapy consisted of 90 mg subcutaneous UST every 8 or 12 weeks. Individual UST concentration time course during treatment were estimated using a population pharmacokinetic (PK) model. Quartile analysis and logistic regression were performed to analyse if UST concentrations at week 8 were associated with biochemical remission rates at week 24 (C-reactive protein (CRP) ≤ 5 mg/L and / or faecal calprotectin (FC) ≤ 250 mg/kg). In total, 124 patients with CD were included. Patients achieving biochemical remission at week 12 and 24 had significantly higher UST levels at week 8 compared to patients without biochemical remission (6.6 µg/mL versus 3.9 µg/mL, P < 0.01 and 6.3 µg/mL versus 3.9 µg/mL, P < 0.01, respectively). In quartile analysis, patients with UST levels in the highest quartile (≥ 6.3 µg/mL at week 8) had higher biochemical remission rates at week 12 and week 24. There was no association between UST levels at and corticosteroid-free clinical remission rates. In this real-world cohort of patients with CD, UST levels in the highest quartile (≥ 6.3 µg/mL) at week 8 were associated with higher biochemical remission rates at week 24.

Identifiants

pubmed: 36920666
doi: 10.1007/s10620-023-07822-7
pii: 10.1007/s10620-023-07822-7
pmc: PMC10188378
doi:

Substances chimiques

Ustekinumab FU77B4U5Z0
C-Reactive Protein 9007-41-4

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2647-2657

Informations de copyright

© 2023. The Author(s).

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Auteurs

Tessa Straatmijer (T)

Department of Gastroenterology and Hepatology, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
Division Gastroenterology-Hepatology, Maastricht University Medical Center+, Maastricht, The Netherlands.

Vince B C Biemans (VBC)

UMC Utrecht, Utrecht, The Netherlands.

Dirk Jan A R Moes (DJAR)

Department of Clinical Pharmacy and Toxicology, Leiden University Medical Centre, Leiden, The Netherlands.

Frank Hoentjen (F)

Division of Gastroenterology, University of Alberta, Edmonton, Canada.
Department of Gastroenterology, Radboud University Medical Centre, Nijmegen, The Netherlands.

Rob Ter Heine (R)

Department of Pharmacy, Radboud Institute for Heulth Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.

P W Jeroen Maljaars (PWJ)

Department of Gastroenterology and Hepatology, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.

Rosaline Theeuwen (R)

Department of Gastroenterology and Hepatology, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.

Marieke Pierik (M)

MUMC+, Maastricht, the Netherlands.

Marjolijn Duijvestein (M)

Department of Gastroenterology, Radboud University Medical Centre, Nijmegen, The Netherlands.

Andrea E van der Meulen-de Jong (AE)

Department of Gastroenterology and Hepatology, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands. ae.meulen@lumc.nl.
Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology Endocrinology Metabolism (AGEM) Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. ae.meulen@lumc.nl.

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