S3192 Ustekinumab Efficacy in Crohn’s Disease: Results of a Real Life Evaluation in a Specialized Center in Brazil

Abstract

INTRODUCTION: Ustekinumab is a monoclonal antibody indicated to the treatment of adult patients with active moderate to severe Crohn’s disease. The objective of this study was to evaluate clinical and laboratory responses after two doses of Ustekinumab for Crohn’s disease in patients without previous biologic therapy and also in patients with failure/tolerance to the treatment with biologics (Anti-TNF or Anti-integrin). METHODS: Medical records of 75 patients were analyzed and, among these, 54 were evaluated clinically and in laboratory between weeks 12 and 16 of treatment. RESULTS: Out of the 54 patients assessed, 27/54 (50%) were women, and regarding previous use of biologics: 36/54 (66.7%) presented failure/tolerance to previous biologic therapy [Ustekinumab was the 4th, 3rd, 5th and 2nd biologic used in 12/54 (33.3%); 10/54 (27.8%); 7/54 (19.4%) and 7/54 (19.4%) patients, respectively]. In the presence of previous biological therapy, favorable response to Ustekinumab was observed in 16/36 (44.4%) and in the group where Ustekinumab was the first biologic drug used, the efficacy observed was 13/18 (72.2%). Fecal calprotectin levels were better in responding patients. Four patients of the casuistry have had concomitant psoriasis (two in each group according to the previous use of biologics) and all of them showed improvement of the lesions after the use of Ustekinumab. CONCLUSION: Ustekinumab seems to be a safe and efficacious medication to treat Crohn’s disease in patients that have not been previously exposed to biologic therapy as well as those who had already been exposed to those therapeutic agents. However, better clinical response was observed in patients that used Ustekinumab as first biologic therapy.