P743 Ustekinumab use in Crohn′s Disease: Does short-term effectiveness correlate to induction regimen?

Abstract

BackgroundEfficacy of ustekinumab (UST) in Crohn's disease (CD) has been demonstrated in clinical trials. If real-world symptomatic response and remission are different depending on the induction regimen (sc or iv) is still unknown.MethodsA retrospective, observational study was conducted in three Spanish hospitals. Response was defined as decrease of HBI ≥3 points and remission as HBI <4. Response and remission were assesed after induction, at 6 and 12 months and at the end of follow-up.ResultsUntil September 2017, 31 CD patients were treated with UST. Twenty-one (67.7%) received sc UST (90 mg, 0, 1, 2, 3) and 10 (32.2%) iv (6 mg/kg) induction followed by UST sc (90 mg sc/8 w) maintenance treatment. Median treatment duration was 19.3 months (3–64). Among these 31 patients (18 female, median age 39.4 years, median disease duration 10.8 years), 24 (77.4%) had failed to 2 or more anti-TNF agents and 6 to one. At time of UST introduction, 7 (22%) patients received immunosuppressant (IS) and 11 (35,4%) steroids. Short-term response after induction was achieved by 22 patients (71%). Response at 6 and 12 month were 80% (16/20) and 70.5% (12/17). Remission at 6 and 12 month were 50 % (10/20) and 58.5% (10/17). The proportion of patients that reached response at the end of follow-up was 45.2% (14/31). When we compared the short-term response by induction regimen we did not find differences (14/21 sc vs. 8/10 iv, p = 0.4). A total of 7 patients (22.6%) needed maintenance dose escalation.ConclusionsUST showed clinical benefit in these CD refractory patients. No differences were found in short-term response by induction regimen (sc or iv).