Ustekinumab in Pediatric Crohn’s Disease Patients: Case Review.

Objectives: We describe the use of ustekinumab for four patients with pediatric Crohn's disease treated at the Seattle Children's Hospital Inflammatory Bowel Disease Center. Methods: A retrospective chart review was done to identify patients' clinical data, disease phenotype, treatment history, and laboratory and growth parameters before treatment with ustekinumab and at last follow up. Adverse events while on ustekinumab were also recorded. Results: Four adolescent patients with Crohn's disease at our center received Ustekinumab. All had previously received corticosteroids, methotrexate, azathioprine/6-mercaptopurine, and both infliximab and adalimumab. Patients had varying disease phenotypes. Ages at ustekinumab initiation were 12, 13, 16, and 17. Weight ranged from 40.5 kg to 57.8 kg, mean 49.5 kg. Two patients showed clinical response and remain on ustekinumab. Two patients discontinued therapy due to continued symptoms and disease complications and required multiple hospitalizations. Conclusions: Ustekinumab was used in four children with pediatric Crohn's disease with two of four patients showing clinical response (one with persistently elevated CRP). A prospective study is needed to define its efficacy, safety, and placement in managing pediatric Crohn's disease in the future. (C) 2016 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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