Efficacy and tolerability of ustekinumab in patients with ulcerative colitis after failure of first-line therapy with genetically engineered biological agents

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Аннотация

Article describes a clinical observation of a 49-year-old female patient with 25-year history of severe steroid-dependent ulcerative colitis (UC). The patient had ineffective/intolerant treatment with 5-aminosalicylic acid, glucocorticosteroids, thiopurines, and budesonide MMX. Remission was achieved with etrolizumab (4.5 years), but a relapse occurred after its discontinuation. During an exacerbation of UC (April 2023, Mayo 3), ustekinumab was prescribed: induction – 6 mg per kilogram intravenously, maintenance therapy – 90 mg subcutaneously every 12 weeks. As a result, it was possible to achieve stable clinical remission lasting 2 years. Endoscopy (April 2025) showed minimal UC activity (Mayo 1), histological examination – disease activity of 2 points according to Riley with the signs of healing. Thus, ustekinumab effectively induced and maintained remission in a female patient with UC refractory to the therapy by genetically engineered biological medicinal product of the first line.

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Авторлар туралы

Alexey Iakovlev

Rostov State Medical University of the Ministry of Healthcare of Russia

Хат алмасуға жауапты Автор.
Email: gastroklinika@yandex.ru
ORCID iD: 0000-0003-1697-8989
SPIN-код: 4699-2807

MD, Dr. Sci. (Medicine), professor, head of the Department of gastroenterology and endoscopy

Ресей, Rostov-on-Don

Alexander Volkov

Rostov State Medical University of the Ministry of Healthcare of Russia

Email: medicina_volkov@mail.ru
ORCID iD: 0009-0000-3227-1225
SPIN-код: 1718-1989

MD, PhD (Medicine), associate professor of the Department of gastroenterology and endoscopy

Ресей, Rostov-on-Don

Olga Bashtovaya

Rostov State Medical University of the Ministry of Healthcare of Russia

Email: gastro_olga@mail.ru
ORCID iD: 0000-0003-1629-2936
SPIN-код: 3829-7735

MD, gastroenterologist at the Department of therapy No. 1 Clinic

Ресей, Rostov-on-Don

Әдебиет тізімі

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2. 1. Colonoscopy of the observed patient dated 04/07/2023: endoscopic picture of erosive and ulcerative colitis, total lesion of the colon (proximal sigmoid colon) (photo by the authors)

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3. Fig. 2. Colonoscopy of the observed patient dated 04/07/2023: endoscopic picture of erosive and ulcerative colitis, total colon lesion with pseudopolypes in the rectum (middle section of the rectal ampoule) (photo by the authors)

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4. 3. Colonoscopy of the observed patient dated 04/23/2025: signs of minimal activity of ulcerative colitis (1 point) focal hyperemia, scarring, deformed vascular pattern (sigmoid colon) (photo by the authors)

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