ABSTRACT

Background

The effectiveness of Ustekinumab (UST) on Crohn's disease (CD)-associated spondyloarthropathy (SpA) is currently unknown.

Research design and methods

All consecutive CD patients with active SpA at the initiation of the treatment with UST were extracted from the cohort of the Sicilian Network for Inflammatory Bowel Diseases (SN-IBD). The primary outcome was the articular response at 8 and 24 weeks, defined as the disappearance of objective signs of arthritis (swelling and/or articular stiffness) and resolution of pain.

Results

Thirty CD patients with active SpA at the initiation of the treatment with UST were assessed. At 24 weeks, 13 patients (43.3%) had an articular response, including 10/18 patients (55.5%) with peripheral SpA and 3/9 patients (33.3%) with axial and peripheral SpA. No patient with axial SpA experienced an articular response. The drop of mean as Harvey-Bradshaw Index values from baseline to week 24 was higher in patients with articular response compared with non-responders (3.8 ± 2.4 vs. 1.3 ± 2.8, p = 0.02).

Conclusions

Our real-world, multicentre experience showed that UST was able to obtain a response on articular symptoms in nearly half of the patients with CD and active SpA after 24 weeks of treatment.

中文翻译：

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Ustekinumab对克罗恩病相关性脊椎关节炎的有效性：来自西西里人炎症性肠病网络（SN-IBD）的真实数据

摘要

背景

Ustekinumab（UST）在克罗恩氏病（CD）相关性脊椎关节炎（SpA）方面的疗效目前未知。

研究设计与方法

从UST治疗开始时，所有连续的具有活动性SpA的CD患者均来自西西里炎性肠病网络（SN-IBD）的队列。主要结果是第8和24周的关节反应，定义为关节炎的客观体征消失（肿胀和/或关节僵硬）和疼痛缓解。

结果

评估了30例在UST治疗开始时具有活动性SpA的CD患者。在第24周时，有13例（43.3％）发生了关节反应，包括10/18例（55.5％）患有外周SpA和3/9例（33.3％）患有轴向和外周SpA。轴向SpA患者均无关节反应。与无反应者相比，有关节反应的患者从基线到第24周的平均Harvey-Bradshaw指数值下降幅度更大（3.8±2.4 vs. 1.3±2.8，p = 0.02）。

结论

我们在现实世界中的多中心经验表明，在治疗24周后，UST能使近一半CD和活动性SpA患者的关节症状得到缓解。