Ustekinumab for anti-tumor necrosis factor refractory pediatric ulcerative colitis: a promising approach towards endoscopic healing

Abstract

erate-to-severe UC that have failed standard treatments. However, primary non-response or secondary loss of response to anti-TNF therapy is often encountered. [3][4][5] Ustekinumab is a humanized monoclonal antibody targeted against the p40 subunit of interleukin (IL)-12 and IL-23 inflammatory cytokines which are involved in intestinal inflammation. This inhibits the signal transduction cascade downstream of Th17 and Th1 inflammatory pathways and thus plays an important role in immune regulation and disease control. 6,7 In 2019 ustekinumab was first approved for treatment of UC in adults after the UNIFI trial demonstrated its efficacy and safety, especially in patients with colitis refractory to anti-TNF treatment. 8 Recent studies involving large pediatric UC cohorts have shown encouraging results. 9,10 However, more longitudinal studies