Ustekinumab improves outcomes in patients with ulcerative colitis

Treatment with ustekinumab can help patients with ulcerative colitis (UC) achieve clinical and endoscopic outcomes of importance after 12 months, results of a real-world study have shown.

In addition, previous exposure to a biologic may result in a lower rate of endoscopic remission.

Overall, 198 patients with moderate to severe UC were included in this retrospective, Canadian multicentre cohort study. Of these, 47.5 percent were female, and 85.9 percent were aged <65 years. Nearly half of the patients (n=87, 47.5 percent) had severe endoscopic activity at baseline, while the majority were bio-exposed (n=176, 88.8 percent; n=66, 33 percent had previous failure of ≥3 biologics).

The researchers followed the participants for a median of 12.8 months after induction.

The overall clinical remission rates were 41.3 percent at 3 months, 38.1 percent at 6 months, and 43.6 percent at 12 months. The corresponding endoscopic remission rates were 8.0 percent, 18.7 percent, and 12.5 percent, which were consistently higher in bio-naïve than bio-exposed patients through 12 months (p<0.05 at all timepoints).

Bio-naïve patients had a higher likelihood of achieving endoscopic remission than bio-exposed patients (hazard ratio, 5.40, 95 percent confidence interval [CI], 1.08‒26.93).

Adverse events occurred in 18 patients (14.1 percent).

In this study, the researchers explored the relationship between baseline factors and 12-month clinical and endoscopic response and remission using univariable logistic regression. Their main focus was the association between outcomes and bioexposure status.