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.
Keywords
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Article info
Publication history
Published online: March 11, 2018
Accepted:
February 28,
2018
Received in revised form:
February 15,
2018
Received:
November 28,
2017
Identification
Copyright
© 2018 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
