Year 2021 / Volume 113 / Number 5
Original
Normalization of long-term quality of life in Crohn’s disease patients receiving ustekinumab

313-317

DOI: 10.17235/reed.2020.6941/2020

Miquel Marquès-Camí, Virginia Robles Alonso, Natalia Borruel, Claudia Herrera de Guise, Luis Mayorga, Francesc Casellas,

Abstract
Background and aim: ustekinumab is a fully human monoclonal antibody against IL-12/23, approved for induction and maintenance treatment of Crohn’s disease (CD). Real-life data shows its true effectiveness in terms of clinical and endoscopic response. However, there is little information regarding health-related quality of life (HRQoL) in CD patients receiving ustekinumab. The main aim of this study was to define long-term clinical remission and HRQoL normalization. The clinical predictive factors of clinical remission were investigated as a secondary aim. Methods: a retrospective, observational study was performed in CD patients under ustekinumab treatment in the Hospital Vall d’Hebron, between January 2009 and January 2019. Clinical remission was defined using the Crohn’s Disease Activity Index (CDAI) and HRQoL normalization was defined by the 36-item Inflammatory Bowel Disease Questionnaire (IBDQ). Results: thirty-three patients were included. The average disease evolution was eleven years (standard deviation [SD]: 8), perianal disease was present in 13 patients (39 %), 30 patients (91 %) had previously been treated with alfa tumor necrosis factor antagonists (anti-TNF) agents and 22 patients (67 %) had a history of intestinal resection. Twenty-four patients (73 %) had undergone one year of treatment. Seventeen patients (51 %) reached clinical remission and six (18 %) restored the HRQoL. No predictors of clinical remission were identified. Conclusions: ustekinumab shows clinical effectiveness in real-life conditions similar to previous data. Normalization of HRQoL is low compared to clinical remission, which may be due to the inaccuracy of the indicator and the severe disease course. Such normalization is a challenge for physicians dealing with inflammatory bowel diseases.
Share Button
New comment
Comments
No comments for this article
References
1. Peyrin-Biroulet L, Sandborn W, Sands BE, Reinisch W, Bemelman W, Bryant R V., et al. Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE): Determining Therapeutic Goals for Treat-to-Target. Am J Gastroenterol. 2015;110(9):1324–38.
2. Huamán JW, Casellas F, Borruel N, Peláez A, Torrejón A, Castells I, et al. Cutoff values of the Inflammatory Bowel Disease Questionnaire to predict a normal health related quality of life. J Crohns Colitis. 2010 Dec;4(6):637–41.
3. Herrera de Guise C, Robles V, Casellas F, Navarro E, Torrejón A, Borruel N. Normalización a largo plazo de la calidad de vida de los pacientes con enfermedad de Crohn con terapia de mantenimiento con adalimumab. Enferm Inflamatoria Intest al Día. 2015;14(1):5–10.
4. Herrera-deGuise C, Casellas F, Robles V, Navarro E, Borruel N. Predictive value of early normalization of quality of life in Crohn’s disease patients receiving antitumor necrosis factor agents. J Gastroenterol Hepatol. 2015 Feb;30(2):286–91.
5. Casellas F, Barreiro De Acosta M, Iglesias M, Robles V, Nos P, Aguas M, et al. Mucosal healing restores normal health and quality of life in patients with inflammatory bowel disease. Eur J Gastroenterol Hepatol. 2012;24(7):762–9.
6. Feagan BG, Sandborn WJ, Gasink C, Jacobstein D, Lang Y, Friedman JR, et al. Ustekinumab as Induction and Maintenance Therapy for Crohn’s Disease. N Engl J Med. 2016; Nov 17;375(20):1946-1960.
7. Sands BE, Han C, Gasink C, Jacobstein D, Szapary P, Gao LL, et al. The effects of Ustekinumab on health-related quality of life in patients with moderate to severe Crohn’s disease. Journal of Crohn’s and Colitis. 2018. 883-895.
8. Liefferinckx C, Verstockt B, Gils A, Noman M, Van Kemseke C, Macken E, et al. Long- term clinical effectiveness of ustekinumab in patients with Crohn’s disease who failed biological therapies: a national cohort study. J Crohn’s Colitis. 2019;
9. Ma C, Fedorak RN, Kaplan GG, Dieleman LA, Devlin SM, Stern N, et al. Clinical, endoscopic and radiographic outcomes with ustekinumab in medically-refractory Crohn’s disease: real world experience from a multicentre cohort. Aliment Pharmacol Ther. 2017 May;45(9):1232–43.
10. Battat R, Kopylov U, Bessissow T, Bitton A, Cohen A, Jain A, et al. Association Between Ustekinumab Trough Concentrations and Clinical, Biomarker, and Endoscopic Outcomes in Patients With Crohn’s Disease. Clin Gastroenterol Hepatol. 2017 Sep;15(9):1427–1434.
11. Wils P, Bouhnik Y, Michetti P, Flourie B, Brixi H, Bourrier A, et al. Subcutaneous Ustekinumab Provides Clinical Benefit for Two-Thirds of Patients With Crohn’s Disease Refractory to Anti-Tumor Necrosis Factor Agents. Clin Gastroenterol Hepatol. 2016;14(2):242–250.
12. Khorrami S, Ginard D, Marín-Jiménez I, Chaparro M, Sierra M, Aguas M, et al. Ustekinumab for the Treatment of Refractory Crohnʼs Disease. Inflamm Bowel Dis. 2016;22(7):1662–9.
13. Kopylov U, Afif W, Cohen A, Bitton A, Wild G, Bessissow T, et al. Subcutaneous ustekinumab for the treatment of anti-TNF resistant Crohn’s disease—The McGill experience. J Crohn’s Colitis. 2014 Nov;8(11):1516–22.
14. Best WR, Becktel JM, Singleton JW, Kern F. Development of a Crohn’s Disease Activity Index. Gastroenterology [Internet]. Elsevier; 1976 Mar 1;70(3):439–44.
15. Ng SC, Plamondon S, Gupta A, Burling D, Kamm MA. Prospective assessment of the effect on quality of life of anti-tumour necrosis factor therapy for perineal Crohn’s fistulas. Aliment Pharmacol Ther. 2009;30(7):757–66.
16. Lopez N, Ramamoorthy S, Sandborn WJ. Recent advances in the management of perianal fistulizing Crohn’s disease: lessons for the clinic. Expert Rev Gastroenterol Hepatol [Internet]. Taylor & Francis; 2019;13(06):1–15.
17. Engel T, Yung DE, Ma C, Pariente B, WIls P, Eliakim R, et al. Effectiveness and safety of Ustekinumab for Crohn’s disease; systematic review and pooled analysis of real-world evidence. Dig Liver Dis. 2019 Jun 12.
18. Barré A, Colombel J-F, Ungaro R. Review article: predictors of response to vedolizumab and ustekinumab in inflammatory bowel disease. Aliment Pharmacol Ther. 2018 Apr;47(7):896–905.
Related articles

Letter

Coincidental oral lesions in Crohn’s disease

DOI: 10.17235/reed.2023.9992/2023

Letter

Duodenal stenosis surgical treatment in Crohn’s disease

DOI: 10.17235/reed.2023.9521/2023

Digestive Diseases Image

Peristomal cutaneous Crohn's disease by contiguity

DOI: 10.17235/reed.2022.8909/2022

Letter

Experience with ustekinumab in reservoir Crohn's disease

DOI: 10.17235/reed.2021.8457/2021

Letter

Anal neoplasia and perianal Crohn’s disease: myth or reality?

DOI: 10.17235/reed.2021.8317/2021

Letter

Crohn’s disease in patients treated with etanercept

DOI: 10.17235/reed.2019.6554/2019

Original

Mercaptopurine and inflammatory bowel disease: the other thiopurine

DOI: 10.17235/reed.2016.4546/2016

Letter to the Editor

Adnexal localization of Crohn’s disease and recurrent massive ovary cysts

DOI: 10.17235/reed.2016.4301/2016

Case Report

Metastatic Crohn’s disease in pediatrics

DOI: 10.17235/reed.2016.3948/2015

Letter to the Editor

Crohn’s disease and Sweet’s syndrome: A debut together

DOI: 10.17235/reed.2015.3842/2015

Case Report

Ovarian involvement in Crohn´s disease: A rare complication

DOI: 10.17235/reed.2015.3764/2015

Citation tools
Marquès-Camí M, Robles Alonso V, Borruel N, Herrera de Guise C, Mayorga L, Casellas F, et all. Normalization of long-term quality of life in Crohn’s disease patients receiving ustekinumab. 6941/2020


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 1392 visits.
This article has been downloaded 191 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 04/02/2020

Accepted: 26/05/2020

Online First: 20/11/2020

Published: 10/05/2021

Article revision time: 106 days

Article Online First time: 290 days

Article editing time: 461 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology