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Beyond Anti-TNF: Is Ustekinumab a Better Choice in Crohn's? - Medscape
Patients considering switching biologics or clinicians choosing a second‑line therapy may care because the study suggests ustekinumab had better long‑term persistence and improving remission rates compared with anti‑TNF agents in this cohort.
The report also notes benefits for some with perianal disease and reductions in fecal calprotectin.
Adult patients with Crohn's disease who have failed anti‑TNF or vedolizumab, patients on biologics, gastroenterologists, and researchers studying biologic sequencing.
What To Know
A retrospective single-center study reported that ustekinumab used as a second-line biologic after anti‑TNF or vedolizumab showed higher treatment persistence than anti‑TNF agents and progressive improvements in clinical remission and fecal calprotectin over follow-up (up to 5 years).
This study compared real-world persistence and clinical outcomes for patients switched to ustekinumab after failing anti‑TNF or vedolizumab. More patients stayed on ustekinumab at 1–3 years versus historical anti‑TNF persistence in the cohort, and clinical remission rates and fecal calprotectin declined over time.
A minority required dose optimization; a small subset discontinued for nonresponse or adverse events. Some patients with perianal disease achieved remission and fistula healing.
How to use this: This is observational, single‑center data—not a randomized trial—so it can inform conversations with clinicians about treatment sequencing and expectations, but does not establish superiority. Discuss individual risks, monitoring, and prior treatment history with your care team.
This is a retrospective, single‑center observational study with a small sample size and limited colonoscopy data; results are hypothesis‑generating rather than definitive. The article summarizes a peer‑reviewed publication in Digestive Diseases and Sciences; talk with your clinician before making treatment changes.
