| International Session（Symposium）2(JSGE・JGES) |
| Thu. November 21st 14:00 - 16:30 Room 11: Portopia Hotel South Wing Topaz |
Objective evaluation of the therapeutic effect of Ustekinumab in patients with Crohn disease
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| Kentaro Murate1, Masanao Nakamura1, Mitsuhiro Fujishiro1 | |||
| 1Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine | |||
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| (Background and Aim) Ustekinumab (UST) was introduced for treatment of Crohn disease (CD). Suitable patients and optimal timing for UST use are not fully understood yet. The aim of this study was to prospectively register the patients who used UST in our hospital and examine the factors for predicting therapeutic effect of UST (UMIN000022512). (Methods) The patients who were introduced UST between June 2017 and February 2019 were registered. We compared patients backgrounds, laboratory data, serum UST and inflammatory cytokine concentration, and cell population in peripheral blood mononuclear cells (PBMC) between two groups, responders and non-responders. (Result) 52 patients were registered. Response rate was 65.9% (29/44) at 8 weeks and 62.5% (10/16) at 48 weeks. Responders were 29 patients. At 8 weeks, mean serum UST concentration in responders was significantly higher (22.15ug/ml) than non-responders (4.26ug/ml). Serum TNF-a concentration in responders decreased from baseline even at 8 weeks (decreased by 50.35pg/ml from baseline) and 48 weeks (decreased by 111.64pg/ml from baseline). In multivariate analysis, high serum TNF-a concentration at baseline was an independent factor for predicting therapeutic effect of UST. Amount of TNF-a induced from dendritic cells and macrophages was more than T lymphocytes by flow cytometry. CD45+CD11b+TNF-a and CD45+CD11c+TNF-a were higher than CD4+ TNF-a. (Conclusion) Serum TNF-a concentration may be a candidate for predicting therapeutic effect of UST |
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Index Term 1: Ustekinumab Index Term 2: Crohn's disease |
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