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Ustekinumab crohn's

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https://www.readbyqxmd.com/read/29667146/cost-effectiveness-analysis-of-crohn-s-disease-treatment-with-vedolizumab-and-ustekinumab-after-failure-of-tumor-necrosis-factor-%C3%AE-antagonist
#1
Przemysław Holko, Paweł Kawalec, Andrzej Pilc
OBJECTIVE: The aim was to evaluate the cost-effectiveness of Crohn's disease (CD) treatment with vedolizumab and ustekinumab after failure of therapy with tumor necrosis factor-α antagonists (anti-TNFs). METHODS: The Markov model incorporated the lifetime horizon, synthesis-based estimates of biologics' efficacy in relation to anti-TNF exposure, and administration of biologics reflecting clinical practice (e.g., sequence of biologics, retreatment, 12-month treatment)...
April 17, 2018: PharmacoEconomics
https://www.readbyqxmd.com/read/29657833/paradoxical-arthritis-occurring-during-anti-tnf-in-patients-with-inflammatory-bowel-disease-histological-and-immunological-features-of-a-complex-synovitis
#2
Stefano Alivernini, Daniela Pugliese, Barbara Tolusso, Laura Bui, Luca Petricca, Luisa Guidi, Luisa Mirone, Gian Ludovico Rapaccini, Francesco Federico, Gianfranco Ferraccioli, Alessandro Armuzzi, Elisa Gremese
Objective: Paradoxical arthritis under tumour necrosis factor inhibitor (TNF-i) for inflammatory bowel disease (IBD) has been described. This study aims to evaluate the histological features of paired synovial tissue (ST) and colonic mucosa (CM) tissue in patients with IBD developing paradoxical arthritis under TNF-i. Methods: Patients with IBD without history of coexisting joint involvement who developed arthritis under TNF-i were enrolled. Each patient underwent ST biopsy and ileocolonoscopy with CM biopsies...
2018: RMD Open
https://www.readbyqxmd.com/read/29623442/therapeutic-drug-monitoring-in-pediatric-inflammatory-bowel-disease
#3
REVIEW
Nicholas Carman, David R Mack, Eric I Benchimol
PURPOSE OF REVIEW: Therapeutic drug monitoring (TDM) has emerged as a useful tool to optimize the use of drug therapies in adults with inflammatory bowel disease (IBD), including both Crohn's disease (CD) and ulcerative colitis (UC), especially during the use of biological therapies, for which the pharmacokinetics and pharmacodynamics are highly variable among patients. Fewer data exist in children. This review examines the current literature on TDM in pediatric IBD. RECENT FINDINGS: Drug clearance is affected by a number of patient and disease factors...
April 5, 2018: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29610516/ustekinumab-iv-6-mg-kg-loading-dose-re-induction-improves-clinical-and-endoscopic-response-in-crohn-s-disease-a-case-series
#4
Sunhee Park, Elisabeth Evans, William J Sandborn, Brigid Boland
No abstract text is available yet for this article.
April 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29610019/ustekinumab-in-the-management-of-crohn-s-disease-expert-opinion
#5
Alessandro Armuzzi, Sandro Ardizzone, Livia Biancone, Fabiana Castiglione, Silvio Danese, Paolo Gionchetti, Ambrogio Orlando, Fernando Rizzello, Maria Lia Scribano, Maurizio Vecchi, Marco Daperno
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...
March 11, 2018: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29593650/hypophysitis-following-treatment-with-ustekinumab-radiological-and-pathological-findings
#6
Ana M Ramos-Leví, Manuel Gargallo, Ana Serrano-Somavilla, Miguel A Sampedro-Núñez, Javier Fraga, Monica Marazuela
Context: Ustekinumab is a human IgG1 monoclonal antibody that targets interleukin (IL)-12 and IL-23, which may be useful in the treatment of autoimmune conditions such as psoriasis, psoriatic arthritis, and Crohn's disease. Hypophysitis is an immune-derived inflammatory condition of the pituitary gland that may lead to pituitary dysfunction. With the increasing use of immunotherapy, it is possible that this and other new immune-related adverse events (IRAEs) arise, although the mechanisms involved are still incompletely defined...
2018: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/29556726/new-treatment-options-for-inflammatory-bowel-diseases
#7
REVIEW
Bram Verstockt, Marc Ferrante, Séverine Vermeire, Gert Van Assche
The advent of anti-TNF agents has dramatically changed the treatment algorithms for IBD in the last 15 years, but primarily and more importantly secondary loss of response is often observed. Fortunately , new treatment options have been actively explored and some have already entered our clinical practice. In the class of anti-cytokine agents, the anti-IL12/IL23 monoclonal antibodies (mAbs) have entered clinical practice with the anti-p40 mAb ustekinumab in Crohn's disease (CD). Also, more selective anti-IL23 agents (anti-p19) have shown efficacy and are being further developed, in contrast to agents inhibiting IL-17 downstream which have failed in clinical trials despite their clear efficacy in psoriasis (Verstockt et al...
March 19, 2018: Journal of Gastroenterology
https://www.readbyqxmd.com/read/29535202/fecal-microbiota-signatures-are-associated-with-response-to-ustekinumab-therapy-among-crohn-s-disease-patients
#8
Matthew K Doherty, Tao Ding, Charlie Koumpouras, Shannon E Telesco, Calixte Monast, Anuk Das, Carrie Brodmerkel, Patrick D Schloss
The fecal microbiota is a rich source of biomarkers that have previously been shown to be predictive of numerous disease states. Less well studied is the effect of immunomodulatory therapy on the microbiota and its role in response to therapy. This study explored associations between the fecal microbiota and therapeutic response of Crohn's disease (CD) patients treated with ustekinumab (UST; Stelara) in the phase 2 CERTIFI study. Using stool samples collected over the course of 22 weeks, the composition of these subjects' fecal bacterial communities was characterized by sequencing the 16S rRNA gene...
March 13, 2018: MBio
https://www.readbyqxmd.com/read/29471605/-emerging-therapies-what-are-promising-in-the-near-future
#9
REVIEW
Geom Seog Seo, Sung Hee Lee
The treatment of inflammatory bowel disease has evolved with the development of anti-TNF agents. In spite of long-term effectiveness, many patients do not respond or no longer responds to these drugs. Therefore, the development of new drugs that act on different inflammatory pathways has become necessary. Vedolizumab, a gut-specific biological agent, inhibits interaction α4β7 integrin with mucosal addressin cell adhesion molecule-1 without inhibiting systemic immune responses. Long-term vedolizumab therapy in patients with Crohn's disease and ulcerative colitis was safe and effective...
February 25, 2018: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/29470778/guselkumab-for-the-treatment-of-psoriasis
#10
REVIEW
Álvaro Machado, Tiago Torres
Psoriasis is a common, chronic, immune-mediated, inflammatory skin disease with systemic involvement and significant impact on patients' quality of life. Several biologic treatments have been developed in recent decades, such as tumor necrosis factor (TNF)-α inhibitors, a non-selective interleukin (IL)-23 inhibitor (ustekinumab, which also inhibits IL-12), and-most recently-IL-17 inhibitors. Guselkumab is a novel biological therapy that selectively targets IL-23 and is the first-in-class selective IL-23 inhibitor approved to treat moderate-to-severe plaque psoriasis...
February 22, 2018: BioDrugs: Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy
https://www.readbyqxmd.com/read/29462391/combination-immunosuppression-in-ibd
#11
Steven Bots, Krisztina Gecse, Murray Barclay, Geert D'Haens
Whether to use biologic treatment for inflammatory bowel disease as monotherapy or in combination with immunosuppressives has been a matter of debate in the last 2 decades. Combination therapy was not superior in any of the registration trials for Crohn's disease and ulcerative colitis for TNF antagonists, vedolizumab, or ustekinumab. It needs to be mentioned, though, that none of these trials were powered to detect such differences, and that many patients entered the trial after having failed conventional immunosuppressives...
February 15, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29445293/clinical-utility-of-ustekinumab-in-crohn-s-disease
#12
REVIEW
Paulo Gustavo Kotze, Christopher Ma, Abdulelah Almutairdi, Remo Panaccione
The introduction of anti-tumor necrosis factor (TNF) therapy marked an important milestone in the management of moderate-to-severe Crohn's disease (CD). However, there remains a pressing demand for alternative therapeutic options for patients with primary nonresponse, secondary loss of response, or intolerable side effects to conventional treatment and TNF antagonists. Ustekinumab (UST) is a fully human IgG1κ monoclonal antibody that inhibits the p40 subunit shared by the proinflammatory cytokines, the interleukin (IL)-12 and -23...
2018: Journal of Inflammation Research
https://www.readbyqxmd.com/read/29430672/review-article-predictors-of-response-to-vedolizumab-and-ustekinumab-in-inflammatory-bowel-disease
#13
REVIEW
A Barré, J-F Colombel, R Ungaro
BACKGROUND: Increased knowledge of pathways involved in the pathogenesis of IBD has led to the development of new treatment options for Crohn's disease (CD) and ulcerative colitis (UC). Two new biological agents have been recently approved for IBD: vedolizumab and ustekinumab. They have different therapeutic targets (α4 β7 integrin for vedolizumab and interleukin-12/23 pathways for ustekinumab) than the primary biological class, anti-tumour necrosis factor alpha (anti-TNF) agents. As the armamentarium for IBD increases in coming years, it will become important to understand factors associated with response in order to best position and personalise therapy...
February 12, 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29409871/pharmacokinetics-and-exposure-response-relationships-of-ustekinumab-in-patients-with-crohn-s-disease
#14
Omoniyi J Adedokun, Zhenhua Xu, Christopher Gasink, Douglas Jacobstein, Philippe Szapary, Jewel Johanns, Long-Long Gao, Hugh M Davis, Steve Hanauer, Brian G Feagan, Subrata Ghosh, William J Sandborn
BACKGROUND AND AIMS: Ustekinumab is a monoclonal antibody that binds with high affinity to the p40 subunit of human interleukin 12 (IL12 and IL23) that has been approved for treatment of patients with moderate to severe Crohn's disease (CD). However, there are few data on its pharmacokinetic properties or the relationship between drug exposure levels and patient response. We collected data from 2 phase 3 induction studies and 1 maintenance study to determine ustekinumab's pharmacokinetic features, relationship between exposure and response, and optimal serum concentrations for efficacy...
January 31, 2018: Gastroenterology
https://www.readbyqxmd.com/read/29383030/immunogenicity-of-biologics-in-inflammatory-bowel-disease
#15
Séverine Vermeire, Ann Gils, Paola Accossato, Sadiq Lula, Amy Marren
Crohn's disease and ulcerative colitis are chronic inflammatory disorders of the gastrointestinal tract. Treatment options include biologic therapies; however, a proportion of patients lose response to biologics, partly due to the formation of anti-drug antibodies (ADAbs). Concomitant immunosuppressive agents reduce the development of ADAbs. This review article aims to assess the immunogenicity of biologic therapies and their clinical implications. A comprehensive literature search was conducted for articles published January 2009 to August 2015 reporting immunogenicity to adalimumab (ADM), certolizumab pegol (CZP), golimumab, infliximab (IFX), ustekinumab, and vedolizumab in inflammatory bowel disease (IBD)...
2018: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/29374617/efficacy-of-medical-therapies-for-fistulizing-crohn-s-disease-systematic-review-and-meta-analysis
#16
REVIEW
Matthew J Lee, Claire E Parker, Sarah R Taylor, Leonardo Guizzetti, Brian G Feagan, Alan J Lobo, Vipul Jairath
BACKGROUND & AIMS: Fistulas are debilitating complications of Crohn's disease (CD) that affect up to 50% of patients. We conducted a systematic review and meta-analysis of randomized controlled trials to assess the efficacy of treatments for fistulizing CD. METHODS: We searched publication databases from inception through December 13, 2016 for trials comparing the efficacy of a therapeutic agent (single or combination) with placebo or another active therapy in adult patients with any form of fistulizing CD...
January 31, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29332708/management-of-psoriasis-in-patients-with-inflammatory-bowel-disease-from-the-medical-board-of-the-national-psoriasis-foundation
#17
REVIEW
Scott M Whitlock, Clinton W Enos, April W Armstrong, Alice Gottlieb, Richard G Langley, Mark Lebwohl, Joseph F Merola, Caitriona Ryan, Michael P Siegel, Jeffrey M Weinberg, Jashin J Wu, Abby S Van Voorhees
BACKGROUND: There is a significant association between psoriasis and inflammatory bowel disease (IBD). Many treatments for psoriasis and psoriatic arthritis are also used for IBD. OBJECTIVE: To assess therapeutic options for patients with psoriasis and concurrent IBD. METHODS: A systematic literature search was performed for clinical studies of biologic and systemic psoriasis medications in psoriasis, psoriatic arthritis, ulcerative colitis, and Crohn's disease, for the period from January 1, 1947, to February 14, 2017...
February 2018: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/29315694/long-term-efficacy-and-safety-of-ustekinumab-in-122-refractory-crohn-s-disease-patients-a-multicentre-experience
#18
P Wils, Y Bouhnik, P Michetti, B Flourie, H Brixi, A Bourrier, M Allez, B Duclos, M Serrero, A Buisson, A Amiot, M Fumery, X Roblin, L Peyrin-Biroulet, J Filippi, G Bouguen, V Abitbol, B Coffin, M Simon, D Laharie, B Pariente
BACKGROUND: Long-term outcome of ustekinumab in Crohn's disease (CD) has not been evaluated. AIM: To evaluate the long-term efficacy and safety of ustekinumab and identify the predictive factors of ustekinumab failure-free persistence in a cohort of anti-TNF refractory CD patients. METHODS: We performed a retrospective multicentre cohort study including all consecutive CD patients who began subcutaneous ustekinumab and presented a clinical response (defined as a significant improvement of CD-related clinical symptoms assessed by the patient's physician leading to continued ustekinumab) during the first year of treatment...
March 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29250117/ustekinumab-and-vedolizumab-dual-biologic-therapy-in-the-treatment-of-crohn-s-disease
#19
Eddie Y Liu, Dustin E Loomes
We present a case of refractory ileocolonic Crohn's disease in a 27-year-old female treated with dual ustekinumab and vedolizumab biologic therapy. She had mucosal healing for the first time in 13 years after a 10-month treatment of ustekinumab overlapped with 6 months of vedolizumab. No side effects were observed during the 6 months of dual biologic therapy. Short-term dual biologic therapy may be considered as a treatment option for induction of remission in refractory cases of Crohn's disease.
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/29220430/postoperative-outcomes-in-ustekinumab-treated-patients-undergoing-abdominal-operations-for-crohn-s-disease
#20
Amy L Lightner, Nicholas P McKenna, Chung Sang Tse, Neil Hyman, Radhika Smith, Gayane Ovsepyan, Phillip Fleshner, Kristen Crowell, Walter Koltun, Marc Ferrante, Andre D'Hoore, Nathalie Lauwers, Bram Verstockt, Antonino Spinelli, Francesca DiCandido, Laura E Raffals, Kellie L Mathis, Edward V Loftus
Introduction: Ustekinumab, a monoclonal antibody targeting interleukins-12 and -23 is used to treat adults with Crohn's disease (CD). We determined the 30-day postoperative infectious complication rate among CD patients who received ustekinumab within 12 weeks prior to an abdominal operation as compared to patients who received anti-tumor necrosis factor (TNF) agents. Methods: A retrospective chart review of adults with CD who underwent an abdominal operation between 1/1/2015 and 5/1/2017 was performed across six sites...
December 6, 2017: Journal of Crohn's & Colitis
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