Case Series: Re-induction of Intravenous, Weight-Based Ustekinumab Is Well Tolerated in Patients With Moderate-Severe Crohn's Disease

Lay Summary Patients with Crohn's disease may benefit from off-label biologic optimization for inadequate response, loss of response, or dose interruption. We report that re-induction with intravenous weight-based ustekinumab was well tolerated and that clinical and endoscopic outcomes improved in some patients with abnormal baseline findings. Background Crohn's disease (CD) patients may benefit from biologic optimization. Methods We retrospectively assessed adverse events (AEs) and clinical/endoscopic response after ustekinumab re-induction in CD patients. Results We identified 28 patients, all with prior biologic exposure. Eight weeks following re-induction, 10.7% reported >= 1 AE. Three serious AEs occurred in a single patient (CD flares). No infusion reactions occurred. 53.8% and 38.5% achieved clinical response and remission, respectively. 42.8% achieved both endoscopic improvement and remission. Conclusions Ustekinumab re-induction was well tolerated. Clinical and endoscopic disease activity improved in some patients. Further larger studies are needed to verify these findings in a broader population.