Ustekinumab in the management of Crohn's disease: Expert opinion

Alessandro Armuzzi, Sandro Ardizzone, Livia Biancone, Fabiana Castiglione, Silvio Danese, Paolo Gionchetti, Ambrogio Orlando, Fernando Rizzello, Maria Lia Scribano, Maurizio Vecchi, Marco Daperno

Research output: Contribution to journalArticle

Abstract

This expert-opinion paper reviews available evidence for the use of ustekinumab, a human interleukin 12/23 monoclonal antibody, in the treatment of Crohn's disease and discusses its potential role in the current treatment scenario for the condition. Ustekinumab appears to be associated with rapid and sustained clinical effect, as reported from the clinical research program, with additional support for potential mucosal healing. These characteristics are paralleled by a favorable safety profile, lack of immunogenicity and the presence of systemic anti-inflammatory activity. Importantly, ustekinumab requires only one single intravenous administration, while subsequent dosing is administered subcutaneously, with potential advantages for home-based therapy. Lastly, the dosage of ustekinumab is flexible. On the basis of the evidence, ustekinumab has a role in patients with primary failure or secondary loss of response to anti-tumor necrosis factor agents, as well as in those who have adverse events on front-line biologics or are reinitiating therapy after a treatment holiday. Current evidence suggests that ustekinumab may be particularly suitable in patients who present extra-intestinal manifestations of the disease or are at risk of infections. Ustekinumab may also be considered in the first-line setting, especially in frail patients, in young subjects or in those who have concomitant immune-mediated diseases.

Original languageEnglish
Pages (from-to)653-660
JournalDigestive and Liver Disease
Volume50
Issue number7
DOIs
Publication statusPublished - 2018

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Keywords

  • Anti-tumor necrosis factor agents
  • Crohn's disease
  • Monoclonal antibodies
  • Ustekinumab
  • Vedolizumab

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Armuzzi, A., Ardizzone, S., Biancone, L., Castiglione, F., Danese, S., Gionchetti, P., Orlando, A., Rizzello, F., Scribano, M. L., Vecchi, M., & Daperno, M. (2018). Ustekinumab in the management of Crohn's disease: Expert opinion. Digestive and Liver Disease, 50(7), 653-660. https://doi.org/10.1016/j.dld.2018.02.017