Ustekinumab intensification in Crohn’s disease: a systematic review
DOI:
https://doi.org/10.30827/ars.v63i4.24740Keywords:
Ustekinumab; optimization; inflammatory bowel diseaseAbstract
Introduction: Ustekinumab emerges as a therapeutic alternative in Crohn’s disease in patients with anti-TNF failure. However, on many occasions, it is common to have to reduce/shorten their administration times to avoid therapeutic failure. The objective of this systematic review is to evaluate the effectiveness of ustekinumab intensification by shortening its therapeutic interval.
Method: A systematic review of the literature based on the guidelines of the PRISMA statement was performed. The Medline, Embase and Web of Science databases were consulted, including studies with adults diagnosed with moderate or severe Crohn’s disease who had undergone a change in ustekinumab dosage as an intervention by shortening the interval to every 4 weeks.
Results: Five articles were included, one of them being a systematic review. At 6 months, clinical remission rates of around 45% are shown, an average reduction of 3 points in the Harvey Bradshaw index over baseline, as well as a normalization of CRP levels in 21% of patients.
Conclusions: The results support the use of ustekinumab interval shortening as an effective and useful therapeutic option for patients with loss of response to the usual regimen. However, it is recommended to carry out new studies of experimental design that increase the level of existing evidence.
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