Intest Res.  2023 Jan;21(1):137-147. 10.5217/ir.2021.00173.

Real-world effectiveness and safety of ustekinumab induction therapy for Korean patients with Crohn’s disease: a KASID prospective multicenter study

• Oh K
• Hong HS
• Ham NS
• Lee J
• Park SH
• Yang SK
• Yoon H
• Kim YS
• Choi CH
• Ye BD
• on behalf of the Korean Association for the Study of Intestinal Diseases

• KMID: 2539012
• DOI: http://doi.org/10.5217/ir.2021.00173

Abstract

Background/Aims
We investigated the real-world effectiveness and safety of ustekinumab (UST) as induction treatment for Koreans with Crohn’s disease (CD).
Methods
CD patients who started UST were prospectively enrolled from 4 hospitals in Korea. All enrolled patients received intravenous UST infusion at week 0 and subcutaneous UST injection at week 8. Clinical outcomes were assessed using Crohn’s Disease Activity Index (CDAI) scores at weeks 8 and 20 among patients with active disease (CDAI ≥150) at baseline. Clinical remission was defined as a CDAI <150, and clinical response was defined as a reduction in CDAI ≥70 points from baseline. Safety and factors associated with clinical remission at week 20 were also analyzed.
Results
Sixty-five patients were enrolled between January 2019 and December 2020. Among 49 patients with active disease at baseline (CDAI ≥150), clinical remission and clinical response at week 8 were achieved in 26 (53.1%) and 30 (61.2%) patients, respectively. At week 20, 27 (55.1%) and 35 (71.4%) patients achieved clinical remission and clinical response, respectively. Twenty-seven patients (41.5%) experienced adverse events, with serious adverse events in 3 patients (4.6%). One patient (1.5%) stopped UST therapy due to poor response. Underweight (body mass index <18.5 kg/m²) (odds ratio [OR], 0.085; 95% confidence interval [CI], 0.014–0.498; P=0.006) and elevated C-reactive protein at baseline (OR, 0.133; 95% CI, 0.022–0.823; P=0.030) were inversely associated with clinical remission at week 20.
Conclusions
UST was effective and well-tolerated as induction therapy for Korean patients with CD.

Keyword

Ustekinumab; Crohn disease; Korea

Figure

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  Fig. 1. Flowchart of patient enrollment. CDAI, Crohn’s Disease Activity Index.

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  Fig. 2. Clinical outcomes at week 8 and week 20 among 49 patients with Crohn’s Disease Activity Index score 150 or over at baseline.

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  Fig. 3. Changes in Crohn’s Disease Activity Index (CDAI) and laboratory values over time. CDAI (A), serum albumin level (B), serum C-reactive protein level (C), and fecal calprotectin level (D) are expressed in means±standard error of the means. The levels of C-reactive protein and fecal calprotectin were log-transformed, analyzed, and back-transformed. aP<0.05, bP<0.001. NS, not significant.

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