Ustekinumab ( Stelara ), an antibody proven to treat the skin condition psoriasis, has now shown positive results in decreasing the debilitating effects of Crohn’s Disease, according to researchers at the University of California San Diego, School of Medicine.
The study has been published in The New England Journal of Medicine ( NEJM ).

Results from the clinical trial showed Ustekinumab increased clinical response and remission in patients suffering from moderate-to-severe Crohn’s Disease - a form of inflammatory bowel disease ( IBD ) that can lead to a variety of distressing symptoms, including diarrhea, intestinal bleeding and weight loss. Serious complications such as bowel obstruction and abscesses can also occur.

A challenge in treating patients with Crohn’s Disease is managing patients whose bodies are resistant to tumor necrosis factor ( TNF ) inhibitors such as Infliximab, Adalimumab and Certolizumab pegol.
Ustekinumab blocks two proteins that cause inflammation, interleukin 12 and 23.

One third of patients with moderate-to-severe Crohn’s disease do not respond to current treatment with TNF inhibitors, which regulates the body’s immune system and inflammation. Another one third of patients only have a temporary response.

Five hundred and twenty six patients were part of the randomized trial, which was conducted in 12 countries. Eligible patients were at least 18 years of age and had a confirmed diagnosis of Crohn’s disease for at least three months.

The patients were treated for 36 weeks in the placebo-controlled study. They were given an intravenous dose of Ustekinumab at the beginning of the study and a subcutaneous dose every eight weeks. Benefits could be seen as early as six weeks of therapy.

Among patients treated, serious infection was reported in five patients and a basal-cell carcinoma, a form of skin cancer, was reported in one patient.

These promising initial results are now being followed up and confirmed with additional phase 3 induction trials, UNITI-1 and UNITI-2. A phase 3 maintenance trial ( IM-UNITI ) will also be conducted in which the patients who respond to Ustekinumab will receive additional treatment for one year.

Crohn’s disease affects approximately 700,000 Americans. There is no cure for the disease, and severe flare ups can result in surgery where the large intestine is removed.

Source: University of California San Diego, 2012

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