Repeated intravenous weight-based ustekinumab maintenance as an optimization strategy for Crohn's disease patients with loss of response to standard therapy.

BACKGROUND

Some patients with Crohn's disease (CD) lose response to Ustekinumab (UST) standard therapy. Currently, there is limited evidence on efficacy of repeated intravenous (IV) weight-based UST maintenance in refractory CD . Here, we investigated the efficacy and safety of the optimization therapy in such patients.

METHODS

In this retrospective study, 134 CD patients who had lost their response to UST were enrolled. Clinical response and remission were assessed at weeks 21 and 42 using the Harvey-Bradshaw Index, while secondary outcomes included biochemical and endoscopic measures. Safety was monitored throughout the study.

RESULTS

At week 21, the clinical response and remission rates were 76.9% and 43.3%, respectively. These rates improved to 88.6% and 73.2% by week 42. Among the 75 patients who underwent endoscopic evaluation, 52.0% achieved endoscopic remission, and 76.0% demonstrated a response. Furthermore, the majority of patients (91.8%, 123/134) remained on the optimization regimen throughout week 42, and no significant adverse events were reported.

CONCLUSION

Repeated IV weight-based UST maintenance has shown significant and sustained clinical, biochemical, and endoscopic improvements in most patients who have lost their response to standard UST therapy. This optimized regimen offers a promising therapeutic strategy for individuals who would otherwise need to switch to other biologics or dual-targeted therapies.