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Master Thesis

Efficacité et sûreté de l'induction intraveineuse d'ustekinumab au sein d'une cohorte de cent patients atteints de maladie de Crohn modérée à sévère en échec des anti-TNF

Abstract : Background and aims: Ustekinumab is a fully human monoclonal antibody targeting the p40 subunit of interleukins-12 and 23 thus inhibiting their receptors on T cells and natural killer cells. Ustekinumab is effective to induce clinical response and remission in patients with moderately to severely active Crohn’s disease (CD) that is refractory to either Tumor Necrosis Factor (TNF) antagonists or conventional therapy in phase III trials. The aim of the study was to describe the real-life experience with ustekinumab intravenous induction in anti-TNF and/or vedolizumab resistant or intolerant CD patients. Methods: We perfomed a retrospective observational open-label study on CD patients receiving ustekinumab intravenous induction between August 2014 and November 2017 in two gastroenterology departments at University Hospital Nord (Marseille) and University Hospital Saint-Eloi (Montpellier). The primary outcome was clinical response at week eight. Results: A total of 100 patients was included. Nighty-nine patients (99%) were resistant or intolerant to one anti-TNF or more and fifty-four (54%) to vedolizumab. Ustekinumab was given to eighty-four (84%) patients for luminal disease activity, to eight (8%) for intolerance to a previous treatment, to seven (7%) for absence of endoscopic or imaging remission and to one patient (1%) for reduce the risk of post operative recidive. Clinical response at week eight was achieved in seventy-four patients (74%) and clinical remission in fifty patients (50%). Conclusion: Ustekinumab intravenous induction is effective in almost three-quarters of patients with CD refractory to at least 1 anti-TNF agent and/or vedolizumab therapy
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https://dumas.ccsd.cnrs.fr/dumas-02413629
Contributor : Faculté de Médecine Amu <>
Submitted on : Monday, December 16, 2019 - 11:49:51 AM
Last modification on : Monday, July 6, 2020 - 4:47:12 PM
Long-term archiving on: : Tuesday, March 17, 2020 - 6:56:03 PM

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Aurélia Santoni. Efficacité et sûreté de l'induction intraveineuse d'ustekinumab au sein d'une cohorte de cent patients atteints de maladie de Crohn modérée à sévère en échec des anti-TNF. Sciences du Vivant [q-bio]. 2018. ⟨dumas-02413629⟩

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