Kerri Glassner, DO, on the Optimal and Future Use of IL-12/23 Inhibitors in IBD

Dr Glassner discusses her presentation at the Advances in Inflammatory Bowel Diseases virtual regional meeting on the positioning and use of interleukin-12/23 inhibitors in the management on inflammatory bowel diseases.

Kerri Glassner, DO, is a gastroenterologist with the Fondren IBD Center at Houston Methodist Hospital in Houston, Texas. 

TRANSCRIPT:

Dr. Kerri Glassner:   Hi, my name is Kerri Glassner. I'm a part of the Fondren Inflammatory Bowel Disease Center at Houston Methodist Hospital.

I gave a talk on the optimal and future use of IL-12/23 inhibitors for IBD at AIBD Regionals. We now have multiple options for the induction and maintenance of remission in moderate-to-severe IBD, which is wonderful news for our patients.

Our job as clinicians is to help select the best therapy for each patient. The goal of my talk was to provide you with key points about ustekinumab to aid you in the decision of when ustekinumab may be a great option.

Studies have shown that ustekinumab is safe and effective for both Crohn's and UC. Multiple studies, including UNITI-1, 2, and IM-UNITI in Crohn's and UNIFI in ulcerative colitis, have shown that ustekinumab is more effective than placebo for the induction and maintenance of remission.

In addition, ustekinumab is effective for both biologic-naive and those who previously failed therapy with anti-TNF inhibitors. We now have five-year long-term extension trial data in Crohn's and two-year data in UC. There were no new deaths, very low rates of adverse events, serious adverse events, and infections.

Another point from my talk is that with anti-TNF therapy, we worry about immunogenicity, whereas ustekinumab has a very low rate of immunogenicity, somewhere around five percent in the clinical trials. Use of a concomitant immunomodulator has not been shown to improve outcomes.

Because ustekinumab is also approved for psoriasis, it may be an excellent option for your IBD patients who also have psoriasis, allowing you to treat both conditions using just one medication.

Current data supports the use of ustekinumab during pregnancy in women with IBD, which is very reassuring for our young females who may be planning to start a family in the future.

Finally, there are several new agents targeting the p19 subunit of IL-23 that are on the horizon and may be even more effective for our patients.