More data emerging that indicates that subcutaneous ustekinumab will be useful for refractory Crohn’s disease: S Khorrami et al. Inflamm Bowel Dis 2016; 22: 1662-69.
- This open-label cohort of 116 patients identified a clinical response (Harvey-Bradshaw Index) in 97 (84%) after loading dose, and clinical benefit in 58% at 12 months of followup.
- Perianal disease improved in 11 of 18 (61%).
- This cohort had refractory disease with almost 90% had failed or were intolerant to 2 or more anti-TNFs.
Another strategy for managing inflammatory bowel disease is using allopurinol which can help low-dose azathioprine achieve therapeutic levels. In the largest cohort to date, Pavlidis et al (Inflamm Bowel Dis 2016; 22: 1639-46) showed that at the end of followup (median 19 months after treatment initiation) 113/164 (69%) of patients with Crohn’s disease and 83/136 (61%) with ulcerative/unclassified colitis had a clinical response; 52% and 54% respectively were in remission. The azathioprine dose was 25% of weight-based monotherapy dose adjusted based on TPMT status; thus, for normal/high TPMT activity, azathioprine was dosed at 0.5 mg/kg whereas for heterozygous/intermediate activity, azathioprine was dosed at 0.25 mg/kg.
Related blog posts:
- Using Ustekinumab for Crohn’s Disease | gutsandgrowth
- CCFA Conference Notes 2016 (part 5) -Emerging … – gutsandgrowth
- Not Much Data with Allopurinol | gutsandgrowth
- Data on Allopurinol | gutsandgrowth
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