March 04, 2020
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Shortened Stelara dose interval may improve activity in Crohn’s disease

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Jacob E. Ollech

Clinical and biological indices of disease activity improved in patients with Crohn’s disease when researchers shortened the Stelara 90 mg dose from every 8 weeks to every 4 weeks.

"Little is known about the effects of shortening the dosing interval for patients with Crohn’s disease who do not respond to ustekinumab at the standard dose of 90 mg every 8 weeks,” Jacob E. Ollech, MD, of the Inflammatory Bowel Disease Center at the University of Chicago Medicine, told Healio Gastroenterology and Liver Disease. “In our study, we reported that shortening the ustekinumab 90 mg dose interval to 4 weeks for patients with [Crohn’s disease] who did not respond to doses every 8 weeks improved clinical and biological indices of disease activity. As such, patients who lose response to the standard dose of ustekinumab might benefit from dose interval shortening."

Ollech and colleagues conducted a retrospective study of 506 patients with Crohn’s disease who received 90 mg of subcutaneous Stelara (ustekinumab, Janssen) every 8 weeks to determine the effectiveness of ustekinumab dose interval shortening. They collected data from 110 patients who initially received 90 mg of subcutaneous ustekinumab every 8 weeks and then had their interval reduced to every 4 weeks.

Before and after the dose interval shortening, the Harvey Bradshaw Index (HBI) scores were available for 78 patients (71%), levels of C-reactive protein for 60 patients (55%) and fecal calprotectin for eight patients (7%).

Results showed after dose interval shortening, the median HBI score decreased from 4.5 to 3 (P = .002), CRP decreased from 8 mg/L to 3 mg/L (P = .031), and fecal calprotectin decreased from 378 g/g to 157 g/g. Among patients with an HBI score greater than 4, a CRP level of at least 5 mg/dL, and a fecal calprotectin level greater than 250 g/g, 28% achieved clinical remission (HBI score 4), 22% had a normal CRP level ( < 5 mg/dL), 50% had reduced fecal calprotectin levels and 36% achieved endoscopic remission after dose interval shortening. – by Monica Jaramillo

 

Disclosure: Ollech reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.