Evidence map›Paper›PMID 34160735›Full record

ArticleDigestive diseases and sciences2022

Real-World Effectiveness and Safety of Ustekinumab in Elderly Crohn's Disease Patients.

Rajat Garg, Manik Aggarwal, Robert Butler, Jean Paul Achkar, Bret Lashner, Jessica Philpott, Benjamin Cohen, Taha Qazi, Florian Rieder, Miguel Regueiro and 1 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Digestive diseases and sciences, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed
5.4field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 35 citations in OpenAlex.

  1. Review
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  8. Real-world effectiveness and safety of ustekinumab and vedolizumab in elderly patients with Crohn's disease.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2023
    Article
  9. The 2023 Impact of Inflammatory Bowel Disease in Canada: Special Populations-IBD in Seniors.Journal of the Canadian Association of Gastroenterology · 2023
    Review
  10. IL-12 and IL-23 pathway inhibition in inflammatory bowel disease.Nature reviews. Gastroenterology & hepatology · 2023
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 1 institution in 1 country.

Rajat GargDepartment of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA.
Manik AggarwalDepartment of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA.
Robert ButlerQuantitative Health Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
Jean Paul AchkarDepartment of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Bret LashnerDepartment of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Jessica PhilpottDepartment of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Benjamin CohenDepartment of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Taha QaziDepartment of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Florian RiederDepartment of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Miguel RegueiroDepartment of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA.
Benjamin ClickDepartment of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA. clickb@ccf.org.ORCID 0000-0003-2582-2812
Cleveland Clinic · US

Funding

Creeping fat and Crohn's disease associated stricturesR01DK123233 · NIDDK · CLEVELAND CLINIC LERNER COM-CWRU · PI RIEDER, FLORIAN · 2020 to 2024
$1.9M
Microbiota in Intestinal FibrosisK08DK110415 · NIDDK · CLEVELAND CLINIC LERNER COM-CWRU · PI RIEDER, FLORIAN · 2016 to 2020
$767k
NIDDK NIH HHS K08 DK110415NIDDK NIH HHS R01 DK123233
6 · The paper itself

Abstract

introductionThe efficacy and safety profile of ustekinumab (UST) in Crohn's disease (CD) is favorable; however, data in elderly patients are lacking. We aimed to assess the safety and efficacy of UST in elderly CD.

methodsWe performed a retrospective cohort study of CD patients classified as elderly (age ≥ 65 years at UST initiation) or nonelderly (<65 years) treated at a large, tertiary referral center. Outcomes assessed were clinical (measured by physician global assessment [PGA]) and steroid-free response, remission, adverse events, and postsurgical complications were compared by age category. Multivariable regression modeling and survival analysis was also performed.

resultsIn total, 117 patients (elderly n = 39, nonelderly n = 78) were included in the study. Elderly patients had predominantly moderate disease (87.2%), while nonelderly had a higher proportion of severe disease activity (44.9%) (p = 0.001), though no differences in baseline endoscopic activity, prior biologic use, or steroid or immunomodulator use at baseline existed (p > 0.05 all). While nearly 90% patients in both groups experienced clinical response to UST, compared to nonelderly, elderly patients were less likely to achieve complete clinical remission (28.2% vs. 52.6%, p = 0.01). On regression modeling, age was not associated with clinical outcomes (p > 0.05 all). Mucosal healing was achieved in 26% elderly and 30% nonelderly patients (p = 0.74). There were no significant differences in infusion reactions (2.6% vs. 6.4%, p = 0.77), infection (5.2% vs. 7.7%, p = 0.7), or postsurgical complications (p = 0.99) by age category.

conclusionUST is safe and effective in elderly CD. Although limited by sample size and retrospective design, such real-world data can inform biologic positioning in this IBD population.

Indexed as

Biological ProductsCrohn DiseaseDermatologic AgentsUstekinumabAgedComparative Effectiveness ResearchHumansRemission InductionRetrospective StudiesTreatment OutcomeBiological ProductsDermatologic AgentsUstekinumabComparative effectivenessCrohn’s diseaseElderlyIBDInflammatory bowel diseaseReal worldUstekinumab

Identifiers

PMID34160735
PMCPMC8867242
OpenAlexW3177328127

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.