Stelara may be effective therapeutic for perianal Crohn’s
Stelara may be an effective therapeutic treatment in perianal refractory Crohn’s disease, according to results from the American Journal of Gastroenterology.
“This large multicenter dedicated study adds substantial evidence to the growing literature on ustekinumab effectiveness in refractory CD,” Constance Chapuis-Biron, MD, from the department of gastroenterology at the University Hospital of Besançon, University Bourgogne Franche-Comté in Besançon, France, said.
Chapuis-Biron and colleagues performed a multicenter retrospective study of 207 patients with either active or inactive perianal CD who received Stelara (ustekinumab, Janssen). Median follow-up was 48 weeks; 56 patients discontinued treatment after a median of 43 weeks. Researchers identified predictors of success using univariate and multivariable logistic regression analyses. They used the Kaplan-Meier method to calculate perianal CD recurrence-free survival in patients with inactive perianal CD.
“In patients with active [perianal CD] at treatment initiation, the success of ustekinumab was defined by clinical success at 6 months assessed by the physician’s judgment without additional medical or surgical treatment for [perianal CD],” the researchers wrote.
Mean duration of CD was 14.3 years and the mean number of prior perianal surgeries was 2.8. Investigators reported 205 patients were previously exposed to at least one anti-TNF and 58 patients to vedolizumab.
Fifty-seven of 148 patients with active perianal CD reached success, according to researchers. Twenty-nine of 88 patients with setons at initiation had successful removal. Absence of optimization correlated with treatment success (OR = 2.74; 95% CI, 0.96–7.82).
According to a multivariable analysis, the number of prior anti-TNF was borderline significant. The probability of recurrence-free survival was 86.2% at 26 weeks and 75.1% at 52 weeks among patients with inactive perianal CD.