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Crohn's disease (CD) is a chronic inflammatory disease of the gastrointestinal tract characterized by relapse and remission.
its incidence and prevalence are increasing year by year, and its main therapeutic objectives are to achieve clinical and endoscopic remission and avoid complications such as fistula and stenosis.
In the past few years, CD treatment options have expanded, and the emergence of conventional drugs such as corticosteroids, thiopental, and especially tumor necrotologist α (TNF-α) antagonists has significantly changed the treatment options for moderate to severe active CD.
tumor necrosis factor α antagonists can induce and maintain clinical remission, but about half of patients lose their response to TNF-α antagonists after a period of treatment.
ustekinumab is a monoclonal antibody against naloxyme 12 (IL-12) and white mesokine 23 (IL-23) p40 subi.
currently approved as a treatment for moderate to severe active CD in the United States, Europe and other countries.
study aims to study whether induced disease activity is associated with clinical response by analyzing serum C-reactive protein (CRP) levels and simple endoscopic scores for Crohn's disease (SES-CD).
selected patients were moderate to severe active CD patients who planned to receive ustekinumab treatment.
At weeks 0, 8, 24, and 48, the differences between responders and non-reactors were compared by assessing patient demographics, simple endoscopic score (SES-CD), ustekinumab and cytokine concentrations, and cell fractions.
results showed that the clinical response and clinical remission rates of the 22 patients in the group were 59.1% and 31.8% in week 8, 68.2% and 45.5% in week 24, and 54.4% and 40.9% respectively in week 48.
there was no significant difference in the demographics and disease characteristics of patients at baseline between responders and non-reactors.
combination of low SES-CD and high serum TNF-α at baselines showed a good correlation with clinical response.
the treatment, serum TNF-α concentration decreased.
the baseline of the respondent, the proportion of CD4 plus TNF-α cells was significantly higher than that of the respondent.
in respondents, the proportion of CD4 plus TNF-α cells decreased with treatment, but not in non-respondents.
this study confirms that a combination of higher serum TNF-α concentrations at baseline and lower SES-CD can help clinicians choose the right treatment for moderate to severe CD patients.
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