Ustekinumab trough levels predicting laboratory and endoscopic remission in patients with Crohn’s disease

Backgrounds Optimal concentration of ustekinumab (UST) predicting endoscopic remission has not been fully investigated in Crohn’s disease (CD). We aimed to identify the optimal UST trough levels predicting clinical, laboratory and endoscopic remission in CD patients. Methods Twenty-eight patients wi...

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Published inBMC gastroenterology Vol. 22; no. 1; pp. 195 - 9
Main Authors Hirayama, Hisashi, Morita, Yasuhiro, Imai, Takayuki, Takahashi, Kenichiro, Yoshida, Atsushi, Bamba, Shigeki, Inatomi, Osamu, Andoh, Akira
Format Journal Article
LanguageEnglish
Published London BioMed Central 21.04.2022
BioMed Central Ltd
Springer Nature B.V
BMC
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ISSN1471-230X
1471-230X
DOI10.1186/s12876-022-02271-4

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Abstract Backgrounds Optimal concentration of ustekinumab (UST) predicting endoscopic remission has not been fully investigated in Crohn’s disease (CD). We aimed to identify the optimal UST trough levels predicting clinical, laboratory and endoscopic remission in CD patients. Methods Twenty-eight patients with CD were enrolled and investigated (27 patients by enteroscopy and 1 by colonoscopy). The endoscopic activity was assessed using the scoring system that applied the Rutgeerts score to observed intestine. Serum UST trough levels and anti-UST antibodies (AUAs) levels were determined by in-house immunoassays. Results Endoscopic activity was negatively correlated with serum UST trough levels (Spearman’s rank correlation coefficient (ρ) = − 0.66, P  = 0.0001) and serum albumin levels (ρ = − 0.60, P  = 0.0007). The endoscopic activity was positively and significantly correlated with CRP (ρ = 0.59, P  = 0.0009) and ESR (ρ = 0.44, P  = 0.033). There was no significant association between the endoscopic score and AUA levels and/or Crohn’s disease activity index (CDAI). Serum UST trough levels and albumin levels were significantly higher in the endoscopic remission group (scores of 0 and 1) than in the non-endoscopic remission group (UST trough, mean 3.3 vs. 1.8 μg/mL). No significant difference was observed in AUAs between the endoscopic remission and non-remission groups. Receiver operation curve (ROC) analysis revealed that the optimal cutoff value of UST trough levels predicting normal CRP and serum albumin levels was 1.7 μg/mL for each, and the optimal cutoff value predicting endoscopic remission was 2.0 μg/mL (AUC: 0.80, 95% CI 0.64–0.96). Conclusion Achievement of endoscopic remission requires higher UST trough levels than required for normalization of CRP and serum albumin levels.
AbstractList Backgrounds Optimal concentration of ustekinumab (UST) predicting endoscopic remission has not been fully investigated in Crohn’s disease (CD). We aimed to identify the optimal UST trough levels predicting clinical, laboratory and endoscopic remission in CD patients. Methods Twenty-eight patients with CD were enrolled and investigated (27 patients by enteroscopy and 1 by colonoscopy). The endoscopic activity was assessed using the scoring system that applied the Rutgeerts score to observed intestine. Serum UST trough levels and anti-UST antibodies (AUAs) levels were determined by in-house immunoassays. Results Endoscopic activity was negatively correlated with serum UST trough levels (Spearman’s rank correlation coefficient (ρ) = − 0.66, P  = 0.0001) and serum albumin levels (ρ = − 0.60, P  = 0.0007). The endoscopic activity was positively and significantly correlated with CRP (ρ = 0.59, P  = 0.0009) and ESR (ρ = 0.44, P  = 0.033). There was no significant association between the endoscopic score and AUA levels and/or Crohn’s disease activity index (CDAI). Serum UST trough levels and albumin levels were significantly higher in the endoscopic remission group (scores of 0 and 1) than in the non-endoscopic remission group (UST trough, mean 3.3 vs. 1.8 μg/mL). No significant difference was observed in AUAs between the endoscopic remission and non-remission groups. Receiver operation curve (ROC) analysis revealed that the optimal cutoff value of UST trough levels predicting normal CRP and serum albumin levels was 1.7 μg/mL for each, and the optimal cutoff value predicting endoscopic remission was 2.0 μg/mL (AUC: 0.80, 95% CI 0.64–0.96). Conclusion Achievement of endoscopic remission requires higher UST trough levels than required for normalization of CRP and serum albumin levels.
Backgrounds Optimal concentration of ustekinumab (UST) predicting endoscopic remission has not been fully investigated in Crohn’s disease (CD). We aimed to identify the optimal UST trough levels predicting clinical, laboratory and endoscopic remission in CD patients. Methods Twenty-eight patients with CD were enrolled and investigated (27 patients by enteroscopy and 1 by colonoscopy). The endoscopic activity was assessed using the scoring system that applied the Rutgeerts score to observed intestine. Serum UST trough levels and anti-UST antibodies (AUAs) levels were determined by in-house immunoassays. Results Endoscopic activity was negatively correlated with serum UST trough levels (Spearman’s rank correlation coefficient (ρ) = − 0.66, P = 0.0001) and serum albumin levels (ρ = − 0.60, P = 0.0007). The endoscopic activity was positively and significantly correlated with CRP (ρ = 0.59, P = 0.0009) and ESR (ρ = 0.44, P = 0.033). There was no significant association between the endoscopic score and AUA levels and/or Crohn’s disease activity index (CDAI). Serum UST trough levels and albumin levels were significantly higher in the endoscopic remission group (scores of 0 and 1) than in the non-endoscopic remission group (UST trough, mean 3.3 vs. 1.8 μg/mL). No significant difference was observed in AUAs between the endoscopic remission and non-remission groups. Receiver operation curve (ROC) analysis revealed that the optimal cutoff value of UST trough levels predicting normal CRP and serum albumin levels was 1.7 μg/mL for each, and the optimal cutoff value predicting endoscopic remission was 2.0 μg/mL (AUC: 0.80, 95% CI 0.64–0.96). Conclusion Achievement of endoscopic remission requires higher UST trough levels than required for normalization of CRP and serum albumin levels.
Optimal concentration of ustekinumab (UST) predicting endoscopic remission has not been fully investigated in Crohn's disease (CD). We aimed to identify the optimal UST trough levels predicting clinical, laboratory and endoscopic remission in CD patients. Twenty-eight patients with CD were enrolled and investigated (27 patients by enteroscopy and 1 by colonoscopy). The endoscopic activity was assessed using the scoring system that applied the Rutgeerts score to observed intestine. Serum UST trough levels and anti-UST antibodies (AUAs) levels were determined by in-house immunoassays. Endoscopic activity was negatively correlated with serum UST trough levels (Spearman's rank correlation coefficient ([rho]) = - 0.66, P = 0.0001) and serum albumin levels ([rho] = - 0.60, P = 0.0007). The endoscopic activity was positively and significantly correlated with CRP ([rho] = 0.59, P = 0.0009) and ESR ([rho] = 0.44, P = 0.033). There was no significant association between the endoscopic score and AUA levels and/or Crohn's disease activity index (CDAI). Serum UST trough levels and albumin levels were significantly higher in the endoscopic remission group (scores of 0 and 1) than in the non-endoscopic remission group (UST trough, mean 3.3 vs. 1.8 [mu]g/mL). No significant difference was observed in AUAs between the endoscopic remission and non-remission groups. Receiver operation curve (ROC) analysis revealed that the optimal cutoff value of UST trough levels predicting normal CRP and serum albumin levels was 1.7 [mu]g/mL for each, and the optimal cutoff value predicting endoscopic remission was 2.0 [mu]g/mL (AUC: 0.80, 95% CI 0.64-0.96). Achievement of endoscopic remission requires higher UST trough levels than required for normalization of CRP and serum albumin levels.
Abstract Backgrounds Optimal concentration of ustekinumab (UST) predicting endoscopic remission has not been fully investigated in Crohn’s disease (CD). We aimed to identify the optimal UST trough levels predicting clinical, laboratory and endoscopic remission in CD patients. Methods Twenty-eight patients with CD were enrolled and investigated (27 patients by enteroscopy and 1 by colonoscopy). The endoscopic activity was assessed using the scoring system that applied the Rutgeerts score to observed intestine. Serum UST trough levels and anti-UST antibodies (AUAs) levels were determined by in-house immunoassays. Results Endoscopic activity was negatively correlated with serum UST trough levels (Spearman’s rank correlation coefficient (ρ) = − 0.66, P = 0.0001) and serum albumin levels (ρ = − 0.60, P = 0.0007). The endoscopic activity was positively and significantly correlated with CRP (ρ = 0.59, P = 0.0009) and ESR (ρ = 0.44, P = 0.033). There was no significant association between the endoscopic score and AUA levels and/or Crohn’s disease activity index (CDAI). Serum UST trough levels and albumin levels were significantly higher in the endoscopic remission group (scores of 0 and 1) than in the non-endoscopic remission group (UST trough, mean 3.3 vs. 1.8 μg/mL). No significant difference was observed in AUAs between the endoscopic remission and non-remission groups. Receiver operation curve (ROC) analysis revealed that the optimal cutoff value of UST trough levels predicting normal CRP and serum albumin levels was 1.7 μg/mL for each, and the optimal cutoff value predicting endoscopic remission was 2.0 μg/mL (AUC: 0.80, 95% CI 0.64–0.96). Conclusion Achievement of endoscopic remission requires higher UST trough levels than required for normalization of CRP and serum albumin levels.
Optimal concentration of ustekinumab (UST) predicting endoscopic remission has not been fully investigated in Crohn's disease (CD). We aimed to identify the optimal UST trough levels predicting clinical, laboratory and endoscopic remission in CD patients. Twenty-eight patients with CD were enrolled and investigated (27 patients by enteroscopy and 1 by colonoscopy). The endoscopic activity was assessed using the scoring system that applied the Rutgeerts score to observed intestine. Serum UST trough levels and anti-UST antibodies (AUAs) levels were determined by in-house immunoassays. Endoscopic activity was negatively correlated with serum UST trough levels (Spearman's rank correlation coefficient (ρ) = - 0.66, P = 0.0001) and serum albumin levels (ρ = - 0.60, P = 0.0007). The endoscopic activity was positively and significantly correlated with CRP (ρ = 0.59, P = 0.0009) and ESR (ρ = 0.44, P = 0.033). There was no significant association between the endoscopic score and AUA levels and/or Crohn's disease activity index (CDAI). Serum UST trough levels and albumin levels were significantly higher in the endoscopic remission group (scores of 0 and 1) than in the non-endoscopic remission group (UST trough, mean 3.3 vs. 1.8 μg/mL). No significant difference was observed in AUAs between the endoscopic remission and non-remission groups. Receiver operation curve (ROC) analysis revealed that the optimal cutoff value of UST trough levels predicting normal CRP and serum albumin levels was 1.7 μg/mL for each, and the optimal cutoff value predicting endoscopic remission was 2.0 μg/mL (AUC: 0.80, 95% CI 0.64-0.96). Achievement of endoscopic remission requires higher UST trough levels than required for normalization of CRP and serum albumin levels.
Optimal concentration of ustekinumab (UST) predicting endoscopic remission has not been fully investigated in Crohn's disease (CD). We aimed to identify the optimal UST trough levels predicting clinical, laboratory and endoscopic remission in CD patients.BACKGROUNDSOptimal concentration of ustekinumab (UST) predicting endoscopic remission has not been fully investigated in Crohn's disease (CD). We aimed to identify the optimal UST trough levels predicting clinical, laboratory and endoscopic remission in CD patients.Twenty-eight patients with CD were enrolled and investigated (27 patients by enteroscopy and 1 by colonoscopy). The endoscopic activity was assessed using the scoring system that applied the Rutgeerts score to observed intestine. Serum UST trough levels and anti-UST antibodies (AUAs) levels were determined by in-house immunoassays.METHODSTwenty-eight patients with CD were enrolled and investigated (27 patients by enteroscopy and 1 by colonoscopy). The endoscopic activity was assessed using the scoring system that applied the Rutgeerts score to observed intestine. Serum UST trough levels and anti-UST antibodies (AUAs) levels were determined by in-house immunoassays.Endoscopic activity was negatively correlated with serum UST trough levels (Spearman's rank correlation coefficient (ρ) = - 0.66, P = 0.0001) and serum albumin levels (ρ = - 0.60, P = 0.0007). The endoscopic activity was positively and significantly correlated with CRP (ρ = 0.59, P = 0.0009) and ESR (ρ = 0.44, P = 0.033). There was no significant association between the endoscopic score and AUA levels and/or Crohn's disease activity index (CDAI). Serum UST trough levels and albumin levels were significantly higher in the endoscopic remission group (scores of 0 and 1) than in the non-endoscopic remission group (UST trough, mean 3.3 vs. 1.8 μg/mL). No significant difference was observed in AUAs between the endoscopic remission and non-remission groups. Receiver operation curve (ROC) analysis revealed that the optimal cutoff value of UST trough levels predicting normal CRP and serum albumin levels was 1.7 μg/mL for each, and the optimal cutoff value predicting endoscopic remission was 2.0 μg/mL (AUC: 0.80, 95% CI 0.64-0.96).RESULTSEndoscopic activity was negatively correlated with serum UST trough levels (Spearman's rank correlation coefficient (ρ) = - 0.66, P = 0.0001) and serum albumin levels (ρ = - 0.60, P = 0.0007). The endoscopic activity was positively and significantly correlated with CRP (ρ = 0.59, P = 0.0009) and ESR (ρ = 0.44, P = 0.033). There was no significant association between the endoscopic score and AUA levels and/or Crohn's disease activity index (CDAI). Serum UST trough levels and albumin levels were significantly higher in the endoscopic remission group (scores of 0 and 1) than in the non-endoscopic remission group (UST trough, mean 3.3 vs. 1.8 μg/mL). No significant difference was observed in AUAs between the endoscopic remission and non-remission groups. Receiver operation curve (ROC) analysis revealed that the optimal cutoff value of UST trough levels predicting normal CRP and serum albumin levels was 1.7 μg/mL for each, and the optimal cutoff value predicting endoscopic remission was 2.0 μg/mL (AUC: 0.80, 95% CI 0.64-0.96).Achievement of endoscopic remission requires higher UST trough levels than required for normalization of CRP and serum albumin levels.CONCLUSIONAchievement of endoscopic remission requires higher UST trough levels than required for normalization of CRP and serum albumin levels.
Backgrounds Optimal concentration of ustekinumab (UST) predicting endoscopic remission has not been fully investigated in Crohn's disease (CD). We aimed to identify the optimal UST trough levels predicting clinical, laboratory and endoscopic remission in CD patients. Methods Twenty-eight patients with CD were enrolled and investigated (27 patients by enteroscopy and 1 by colonoscopy). The endoscopic activity was assessed using the scoring system that applied the Rutgeerts score to observed intestine. Serum UST trough levels and anti-UST antibodies (AUAs) levels were determined by in-house immunoassays. Results Endoscopic activity was negatively correlated with serum UST trough levels (Spearman's rank correlation coefficient ([rho]) = - 0.66, P = 0.0001) and serum albumin levels ([rho] = - 0.60, P = 0.0007). The endoscopic activity was positively and significantly correlated with CRP ([rho] = 0.59, P = 0.0009) and ESR ([rho] = 0.44, P = 0.033). There was no significant association between the endoscopic score and AUA levels and/or Crohn's disease activity index (CDAI). Serum UST trough levels and albumin levels were significantly higher in the endoscopic remission group (scores of 0 and 1) than in the non-endoscopic remission group (UST trough, mean 3.3 vs. 1.8 [mu]g/mL). No significant difference was observed in AUAs between the endoscopic remission and non-remission groups. Receiver operation curve (ROC) analysis revealed that the optimal cutoff value of UST trough levels predicting normal CRP and serum albumin levels was 1.7 [mu]g/mL for each, and the optimal cutoff value predicting endoscopic remission was 2.0 [mu]g/mL (AUC: 0.80, 95% CI 0.64-0.96). Conclusion Achievement of endoscopic remission requires higher UST trough levels than required for normalization of CRP and serum albumin levels. Keywords: Ustekinumab, Therapeutic drug monitoring, Enteroscopy
ArticleNumber 195
Audience Academic
Author Inatomi, Osamu
Andoh, Akira
Hirayama, Hisashi
Yoshida, Atsushi
Imai, Takayuki
Bamba, Shigeki
Takahashi, Kenichiro
Morita, Yasuhiro
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  organization: Department of Medicine, Shiga University of Medical Science
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  surname: Morita
  fullname: Morita, Yasuhiro
  organization: Department of Medicine, Shiga University of Medical Science
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  givenname: Takayuki
  surname: Imai
  fullname: Imai, Takayuki
  organization: Department of Medicine, Shiga University of Medical Science
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  givenname: Kenichiro
  surname: Takahashi
  fullname: Takahashi, Kenichiro
  organization: Department of Medicine, Shiga University of Medical Science
– sequence: 5
  givenname: Atsushi
  surname: Yoshida
  fullname: Yoshida, Atsushi
  organization: Center for Gastroenterology and Inflammatory Bowel Disease, Ofuna Chuo Hospital
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  givenname: Shigeki
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  fullname: Inatomi, Osamu
  organization: Department of Medicine, Shiga University of Medical Science
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  givenname: Akira
  surname: Andoh
  fullname: Andoh, Akira
  email: andoh@belle.shiga-med.ac.jp
  organization: Department of Medicine, Shiga University of Medical Science
BackLink https://www.ncbi.nlm.nih.gov/pubmed/35448957$$D View this record in MEDLINE/PubMed
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Issue 1
Keywords Therapeutic drug monitoring
Ustekinumab
Enteroscopy
Language English
License 2022. The Author(s).
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Snippet Backgrounds Optimal concentration of ustekinumab (UST) predicting endoscopic remission has not been fully investigated in Crohn’s disease (CD). We aimed to...
Optimal concentration of ustekinumab (UST) predicting endoscopic remission has not been fully investigated in Crohn's disease (CD). We aimed to identify the...
Backgrounds Optimal concentration of ustekinumab (UST) predicting endoscopic remission has not been fully investigated in Crohn's disease (CD). We aimed to...
Backgrounds Optimal concentration of ustekinumab (UST) predicting endoscopic remission has not been fully investigated in Crohn’s disease (CD). We aimed to...
Abstract Backgrounds Optimal concentration of ustekinumab (UST) predicting endoscopic remission has not been fully investigated in Crohn’s disease (CD). We...
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SubjectTerms Albumin
Biological products
Care and treatment
Colon
Colonoscopy
Crohn Disease - drug therapy
Crohn's disease
Diagnosis
Drug utilization
Endoscopy
Endoscopy, Gastrointestinal
Enteroscopy
Gastroenterology
Hepatology
Humans
Inflammatory bowel disease
Internal Medicine
Intestine
Laboratories
Medicine
Medicine & Public Health
Methods
Monoclonal antibodies
Ostomy
Pathogenesis
Patients
Remission
Remission (Medicine)
Remission Induction
Risk factors
Serum Albumin
Therapeutic drug monitoring
Ustekinumab
Ustekinumab - therapeutic use
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Title Ustekinumab trough levels predicting laboratory and endoscopic remission in patients with Crohn’s disease
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