Two Strikes but Not Out: Deep Remission of Ulcerative Colitis with Ustekinumab After Primary Non-response to Infliximab and Vedolizumab

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References

  1. 1.

    Fumery M, Singh S, Dulai PS, Gower-Rousseau C, Peyrin-Biroulet L, Sandborn WJ. Natural history of adult ulcerative colitis in population-based cohorts: a systematic review. Clin Gastroenterol Hepatol. 2018;16:343–356.e3. https://doi.org/10.1016/j.cgh.2017.06.016.

    Article  PubMed  Google Scholar 

  2. 2.

    Geremia A, Biancheri P, Allan P, Corazza GR, Di Sabatino A. Innate and adaptive immunity in inflammatory bowel disease. Autoimmun Rev. 2014;13:3–10. https://doi.org/10.1016/j.autrev.2013.06.004.

    Article  PubMed  CAS  Google Scholar 

  3. 3.

    Singh S, Murad MH, Fumery M, Dulai PS, Sandborn WJ. First- and second-line pharmacotherapies for patients with moderate to severely active ulcerative colitis: an updated network meta-analysis. Clin Gastroenterol Hepatol. 2020;18:2179–2191.e6. https://doi.org/10.1016/j.cgh.2020.01.008.

    Article  PubMed  CAS  Google Scholar 

  4. 4.

    Sands BE, Peyrin-Biroulet L, Loftus EV et al. Vedolizumab versus adalimumab for moderate-to-severe ulcerative colitis. N Engl J Med. 2019;381:1215–1226. https://doi.org/10.1056/NEJMoa1905725.

    Article  PubMed  CAS  Google Scholar 

  5. 5.

    Sands BE, Sandborn WJ, Panaccione R et al. Ustekinumab as induction and maintenance therapy for ulcerative colitis. N Engl J Med. 2019;381:1201–1214. https://doi.org/10.1056/NEJMoa1900750.

    Article  PubMed  CAS  Google Scholar 

  6. 6.

    Panaccione R, Danese S, Sandborn WJ et al. Ustekinumab is effective and safe for ulcerative colitis through 2 years of maintenance therapy. Aliment Pharmacol Ther. 2020;52:1658–1675. https://doi.org/10.1111/apt.16119.

    Article  PubMed  CAS  Google Scholar 

  7. 7.

    Welty M, Mesana L, Padhiar A et al. Efficacy of ustekinumab vs. advanced therapies for the treatment of moderately to severely active ulcerative colitis: a systematic review and network meta-analysis. Curr Med Res Opin. 2020;36:595–606. https://doi.org/10.1080/03007995.2020.1716701.

    Article  PubMed  CAS  Google Scholar 

  8. 8.

    Koder S, Repnik K, Ferkolj I et al. Genetic polymorphism in ATG16L1 gene influences the response to adalimumab in Crohn’s disease patients. Pharmacogenomics. 2015;16:191–204. https://doi.org/10.2217/pgs.14.172.

    Article  PubMed  CAS  Google Scholar 

  9. 9.

    Niess JH, Klaus J, Stephani J et al. NOD2 polymorphism predicts response to treatment in Crohn’s disease–first steps to a personalized therapy. Dig Dis Sci. 2012;57:879–886. https://doi.org/10.1007/s10620-011-1977-3.

    Article  PubMed  CAS  Google Scholar 

  10. 10.

    Hampe J, Franke A, Rosenstiel P et al. A genome-wide association scan of nonsynonymous SNPs identifies a susceptibility variant for Crohn disease in ATG16L1. Nat Genet. 2007;39:207–211. https://doi.org/10.1038/ng1954.

    Article  PubMed  CAS  Google Scholar 

  11. 11.

    Sazonovs A, Kennedy NA, Moutsianas L et al. HLA-DQA1*05 carriage associated with development of anti-drug antibodies to infliximab and adalimumab in patients with crohn’s disease. Gastroenterology. 2020;158:189–199. https://doi.org/10.1053/j.gastro.2019.09.041.

    Article  PubMed  CAS  Google Scholar 

  12. 12.

    Liu M, Degner J, Davis JW et al. Identification of HLA-DRB1 association to adalimumab immunogenicity. PLoS ONE. 2018;13:e0195325. https://doi.org/10.1371/journal.pone.0195325.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  13. 13.

    Mahajna H, Ben-Horin S. Novel bio-genetic predictors of response to biologic treatment in inflammatory bowel diseases. Curr Opin Pharmacol. 2020;55:132–140. https://doi.org/10.1016/j.coph.2020.10.011.

    Article  PubMed  CAS  Google Scholar 

  14. 14.

    Yilmaz B, Juillerat P, Øyås O et al. Microbial network disturbances in relapsing refractory Crohn’s disease. Nat Med. 2019;25:323–336. https://doi.org/10.1038/s41591-018-0308-z.

    Article  PubMed  CAS  Google Scholar 

  15. 15.

    Magnusson MK, Strid H, Sapnara M et al. Anti-TNF therapy response in patients with ulcerative colitis is associated with colonic antimicrobial peptide expression and microbiota composition. J Crohns Colitis. 2016;10:943–952. https://doi.org/10.1093/ecco-jcc/jjw051.

    Article  PubMed  Google Scholar 

  16. 16.

    Zhou Y, Xu ZZ, He Y et al. Gut microbiota offers universal biomarkers across ethnicity in inflammatory bowel disease diagnosis and infliximab response prediction. mSystems. 2018. https://doi.org/10.1128/mSystems.00188-17.

    Article  PubMed  PubMed Central  Google Scholar 

  17. 17.

    Dovrolis N, Michalopoulos G, Theodoropoulos GE et al. The interplay between mucosal microbiota composition and host gene-expression is linked with infliximab response in inflammatory bowel diseases. Microorganisms. 2020. https://doi.org/10.3390/microorganisms8030438.

    Article  PubMed  PubMed Central  Google Scholar 

  18. 18.

    Ananthakrishnan AN, Luo C, Yajnik V et al. Gut microbiome function predicts response to anti-integrin biologic therapy in inflammatory bowel diseases. Cell Host Microbe. 2017;21:603-610.e3. https://doi.org/10.1016/j.chom.2017.04.010.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  19. 19.

    Amiot A, Filippi J, Abitbol V et al. Effectiveness and safety of ustekinumab induction therapy for 103 patients with ulcerative colitis: a GETAID multicentre real-world cohort study. Aliment Pharmacol Ther. 2020;51:1039–1046. https://doi.org/10.1111/apt.15717.

    Article  PubMed  CAS  Google Scholar 

  20. 20.

    Colombel JF, Rutgeerts P, Reinisch W et al. Early mucosal healing with infliximab is associated with improved long-term clinical outcomes in ulcerative colitis. Gastroenterology. 2011;141:1194–1201. https://doi.org/10.1053/j.gastro.2011.06.054.

    Article  PubMed  CAS  Google Scholar 

  21. 21.

    Christensen B, Hanauer SB, Erlich J et al. Histologic normalization occurs in ulcerative colitis and is associated with improved clinical outcomes. Clin Gastroenterol Hepatol. 2017;15:1557-1564.e1. https://doi.org/10.1016/j.cgh.2017.02.016.

    Article  PubMed  PubMed Central  Google Scholar 

  22. 22.

    Li K, Marano C, Zhang H et al. Relationship between combined histologic and endoscopic endpoints and efficacy of ustekinumab treatment in patients with ulcerative colitis. Gastroenterology. 2020. https://doi.org/10.1053/j.gastro.2020.08.037.

    Article  PubMed  PubMed Central  Google Scholar 

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Correspondence to Rachel W. Winter.

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Dalal, R.S., Ananthakrishnan, A.N., Hamilton, M.J. et al. Two Strikes but Not Out: Deep Remission of Ulcerative Colitis with Ustekinumab After Primary Non-response to Infliximab and Vedolizumab. Dig Dis Sci 66, 733–737 (2021). https://doi.org/10.1007/s10620-021-06852-3

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Keywords

  • Inflammatory bowel diseases
  • Ulcerative colitis
  • Biologic
  • Remission
  • Non-responder
  • Ustekinumab
  • Anti-TNF