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P541 Real-life effectiveness of ustekinumab in inflammatory bowel disease patients with concomitant psoriasis or psoriatic arthritis: an IG-IBD study

D. Pugliese*1, M. Daperno2, G. Fiorino3, E. Savarino4, E. Mosso5, L. Biancone6, A. Testa7, L. Sarpi8, M. Cappello9, G. Bodini10, F. Caprioli11, S. Festa12, G. Laino13, G. Maconi14, S. Mazzuoli15, G. Mocci16, A. Sartini17, A. D'Amore18, S. Alivernini19, E. Gremese19, A. Armuzzi20

1Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore, OU IBD Presidio Columbus, Rome, Italy, 2A.O. Ordine Mauriziano, Gastroenterology Unit, Turin, Italy, 3Humanitas Research Hospital, IBD Center, Department of Gastroenterology, Rozzano, Italy, 4University of Padua, Gastroenterology Unit, Department Surgery, Oncology and Gastroenterology, Padua, Italy, 5General and Specialistic Medicine/Gastroenterology, Città della Salute e della Scienza di Torino, Turin, Italy, 6University of Rome Tor Vergata, Department of Systems Medicine, Gastroenterology, Rome, Italy, 7Federico II University, Gastroenterology, Naples, Italy, 8Gastroenterologia ed Endoscopia Digestiva Aziendale USL Umbria1, Perugia, Italy, 9Gastroenterology and Hepatology Section, DiBiMis, Palermo, Italy, 10University of Genoa, Gastrointestinal Unit, Department of Internal Medicine, Genoa, Italy, 11Department of Pathophysiology and Transplantation, University of Milan and Gastroenterology and Endoscopy Unit, IRCCS Cà Granda, IRCCS Policlinico Hospital, Milan, Italy, 12San Filippo Neri Hospital, IBD Unit, Rome, Italy, 13Department of New Technologies and Translational Research in Medicine and Surgery, Pisa, Italy, 14Luigi Sacco University Hospital, Gastroenterology and IBD Unit, Milan, Italy, 15San Nicola Pellegrino Hospital, Gastroenterology Unit, Trani, Italy, 16‘Brotzu’ Hospital, Division of Gastroenterology, Cagliari, Italy, 17University of Modena and Reggio Emilia, Department of Internal Medicine, Gastroenterology Unit, Modena, Italy, 18Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore, Department of Dermatology, Rome, Italy, 19Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore, Division of Rheumatology, Rome, Italy, 20OU IBD Presidio Columbus, Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore, Rome, Italy

Background

Ustekinumab has been licensed for treating psoriasis, psoriatic arthritis and Crohn’s disease. Few data exist regarding the effectiveness of ustekinumab in inflammatory bowel disease (IBD) patients treated for concomitant dermatological or rheumatological conditions. This study aimed to describe the outcomes of IBD patients who received subcutaneous ustekinumab through a dermatological or rheumatological prescription.

Methods

This multi-centre, retrospective study included all IBD patients who were started on subcutaneous ustekinumab for concomitant active psoriasis or psoriatic arthritis, irrespective of IBD activity. The primary endpoint was overall ustekinumab persistence, defined as the maintenance of therapy because of sustained clinical benefit for IBD.

Results

Seventy IBD patients (64 Crohn’s disease / 6 ulcerative colitis) were enrolled. Most patients (95.7%) had been previously exposed to anti-TNFα drugs. The median follow-up on ustekinumab therapy was 10.7 months (range, 1.4–67.3). Twelve patients (17.1%) withdrew the treatment after a median of 7.4 months (range, 0.9–23.8). The cumulative probability of maintaining ustekinumab treatment was 97.1% at 6 months and 77.1% at 12 months. Among the 56 patients with active IBD at baseline, 34 (60.7%) were in clinical remission at the last follow-up visit, and their cumulative probability of achieving IBD clinical remission was 84.7% and 63.9% at 6 and 12 months, respectively. Ustekinumab induced clinical remission of psoriasis or psoriatic arthritis in 37/45 (82.2%) and in 15/25 (60%) patients, respectively. Nine patients experienced an adverse event, but only two stopped ustekinumab.

Conclusion

Subcutaneous ustekinumab had a good effectiveness profile for IBD patients treated for concomitant dermatological or rheumatological conditions.