Skip to Main content Skip to Navigation
Journal articles

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

Abstract : 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. Aims: 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. Conclusion: Ustekinumab seemed to be more effective than azathioprine in preventing POR in this cohort of CD patients.
Complete list of metadata

https://hal.inrae.fr/hal-03293162
Contributor : Christine Molé <>
Submitted on : Tuesday, July 20, 2021 - 5:42:06 PM
Last modification on : Thursday, September 9, 2021 - 11:34:06 AM

File

2021_Buisson_UEG_Journal.pdf
Publisher files allowed on an open archive

Licence


Distributed under a Creative Commons Attribution - NonCommercial - NoDerivatives 4.0 International License

Identifiers

Collections

Citation

Anthony Buisson, Stéphane Nancey, Luc Manlay, David Rubin, Xavier Hebuterne, et al.. Ustekinumab is more effective than azathioprine to prevent endoscopic postoperative recurrence in Crohn's disease. United European Gastroenterology Journal, SAGE Publications, 2021, 9 (5), pp.552-560. ⟨10.1002/ueg2.12068⟩. ⟨hal-03293162⟩

Share

Metrics

Record views

85

Files downloads

95