Title :

Ustekinumab is more effective than azathioprine to prevent endoscopic postoperative recurrence in crohn's disease

Author(s) :

Buisson, Anthony [Auteur]
Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte [M2iSH]
Service Hépato-Gastro-Entérologie [CHU Clermont-Ferrand]
Infection Inflammation et Interaction Hôtes Pathogènes [CHU Clermont-Ferrand] [3IHP ]
Nancey, Stéphane [Auteur]
Centre International de Recherche en Infectiologie [CIRI]
Centre Hospitalier Lyon Sud [CHU - HCL] [CHLS]
Manlay, Luc [Auteur]
Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte [M2iSH]
Service Hépato-Gastro-Entérologie [CHU Clermont-Ferrand]
Infection Inflammation et Interaction Hôtes Pathogènes [CHU Clermont-Ferrand] [3IHP ]
Rubin, David T. [Auteur]
The University of Chicago Medicine [Chicago]
Hebuterne, Xavier [Auteur]
Centre Hospitalier Universitaire de Nice [CHU Nice]
Université Côte d'Azur [UniCA]
Pariente, Benjamin [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Service des Maladies de l'Appareil Digestif et de la Nutrition [CHRU Lille]
Fumery, Mathurin [Auteur]
Université de Picardie Jules Verne [UPJV]
Périnatalité et Risques Toxiques - UMR INERIS_I 1 UPJV [PERITOX]
Service d'Hépato Gastroenterologie [CHU Amiens-Picardie]
Laharie, David [Auteur]
Service d'Hépato-Gastro-Entérologie
Centre Hospitalier Universitaire de Bordeaux [CHU Bordeaux]
Roblin, Xavier [Auteur]
Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] [CHU ST-E]
Bommelaer, Gilles [Auteur]
Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte [M2iSH]
Service Hépato-Gastro-Entérologie [CHU Clermont-Ferrand]
Pereira, Bruno [Auteur]
Direction de la Recherche Clinique et de l’Innovation [CHU Clermont-Ferrand] [DRCI]
Peyrin-Biroulet, Laurent [Auteur]
Centre Hospitalier Régional Universitaire de Nancy [CHRU Nancy]
Vuitton, Lucine [Auteur]
Service de Gastro-Entérologie [CHRU Besançon]

Journal title :

United European Gastroenterology Journal

Abbreviated title :

United European Gastroenterol. J.

Publication date :

2021-05-05

ISSN :

2050-6406

Keyword(s) :

Crohn&apos
ustekinumab
postoperative recurrence
s disease
azathioprine

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

BACKGROUND: Preventing postoperative recurrence (POR) is a major concern in Crohn's disease (CD). While azathioprine is an option, no data is available on ustekinumab efficacy in this situation. OBJECTIVE: We compared the ...
Show more >BACKGROUND: Preventing postoperative recurrence (POR) is a major concern in Crohn's disease (CD). While azathioprine is an option, no data is available on ustekinumab efficacy in this situation. OBJECTIVE: We compared the effectiveness of ustekinumab versus azathioprine in preventing endoscopic POR in CD. METHODS: We retrospectively collected data from all consecutive CD patients treated with ustekinumab after intestinal resection in 9 centers. The control group (azathioprine alone) was composed of patients who participated in a randomized controlled trial conducted in the same centers comparing azathioprine alone or in combination with curcumin. Propensity score analyses (inversed probability of treatment weighting = IPTW) were applied to compare the two groups. The primary endpoint was endoscopic POR (Rutgeerts' index ≥ i2) at 6 months. RESULTS: Overall, 32 patients were included in the ustekinumab group and 31 in the azathioprine group. The propensity score analysis was adjusted on the main risk factors (smoking, fistulizing phenotype, prior bowel resection, resection length >30 cm and ≥2 biologics before surgery) and thiopurines or ustekinumab exposure prior to surgery making the two arms comparable (∣d∣ < 0.2). After IPTW, the rate of endoscopic POR at 6 months was lower in patients treated with ustekinumab compared to azathioprine (28.0% vs. 54.5%, p = 0.029). After IPTW, the rates of i2b-endoscopic POR (Rutgeerts' index ≥ i2b) and severe endoscopic POR (Rutgeerts' index ≥ i3) were 20.8% versus 42.5% (p = 0.066) and 16.9% versus 27.9% (p = 0.24), in the ustekinumab and azathioprine groups, respectively. CONCLUSIONS: Ustekinumab seemed to be more effective than azathioprine in preventing POR in this cohort of CD patients.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
Inserm
Université de Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Submission date :

2021-07-06T12:50:48Z
2024-03-04T11:37:53Z