
Anti–interleukin-23 Medications and Durable Remission for Patients With Crohn's Disease
07/21/22 • 25 min
Drs Peter Higgins and Raja Atreya discuss the phenomenon of durable drug free remission in a subset of patients with Crohn's disease and the future of intermittent induction and sequencing of therapies.
Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/967625). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.
Resources
Efficacy and Safety of Mirikizumab in a Randomized Phase 2 Study of Patients With Crohn's Disease https://linkinghub.elsevier.com/retrieve/pii/S0016-5085(21)03725-2
Long-Term Safety and Efficacy of Risankizumab Treatment in Patients with Crohn's Disease: Results from the Phase 2 Open-Label Extension Study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8684487/
Five-Year Efficacy and Safety of Ustekinumab Treatment in Crohn's Disease: The IM-UNITI Trial https://linkinghub.elsevier.com/retrieve/pii/S1542-3565(21)00203-2
Ustekinumab as Induction and Maintenance Therapy for Crohn's Disease https://www.nejm.org/doi/full/10.1056/NEJMoa1602773
Risankizumab as Induction Therapy for Crohn's Disease: Results from the Phase 3 ADVANCE and MOTIVATE Induction Trials https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00467-6/fulltext
Risankizumab as Maintenance Therapy for Moderately to Severely Active Crohn's Disease: Results from the Multicentre, Randomised, Double-Blind, Placebo-Controlled, Withdrawal Phase 3 FORTIFY Maintenance Trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00466-4/fulltext
A37 Efficacy and Safety of Risankizumab as Maintenance Therapy in Patients With Crohn's Disease: 52 Week Results From the Phase 3 Fortify Study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8859234/
Th17 Cells in Inflammatory Bowel Disease: Cytokines, Plasticity, and Therapies https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7846404
Expansion of IL-23 Receptor Bearing TNFR2+ T Cells Is Associated With Molecular Resistance to Anti-TNF Therapy in Crohn's Disease https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6580782/
Comparative Efficacy and Safety of Biologic Therapies for Moderate-to-Severe Crohn's Disease: A Systematic Review and Network Meta-analysis https://linkinghub.elsevier.com/retrieve/pii/S2468-1253(21)00312-5
European Crohn's and Colitis Organisation https://www.ecco-ibd.eu/
Mercaptopurine Therapy and TPMT and NUDT15 Genotype https://www.ncbi.nlm.nih.gov/books/NBK100660/
Drs Peter Higgins and Raja Atreya discuss the phenomenon of durable drug free remission in a subset of patients with Crohn's disease and the future of intermittent induction and sequencing of therapies.
Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/967625). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.
Resources
Efficacy and Safety of Mirikizumab in a Randomized Phase 2 Study of Patients With Crohn's Disease https://linkinghub.elsevier.com/retrieve/pii/S0016-5085(21)03725-2
Long-Term Safety and Efficacy of Risankizumab Treatment in Patients with Crohn's Disease: Results from the Phase 2 Open-Label Extension Study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8684487/
Five-Year Efficacy and Safety of Ustekinumab Treatment in Crohn's Disease: The IM-UNITI Trial https://linkinghub.elsevier.com/retrieve/pii/S1542-3565(21)00203-2
Ustekinumab as Induction and Maintenance Therapy for Crohn's Disease https://www.nejm.org/doi/full/10.1056/NEJMoa1602773
Risankizumab as Induction Therapy for Crohn's Disease: Results from the Phase 3 ADVANCE and MOTIVATE Induction Trials https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00467-6/fulltext
Risankizumab as Maintenance Therapy for Moderately to Severely Active Crohn's Disease: Results from the Multicentre, Randomised, Double-Blind, Placebo-Controlled, Withdrawal Phase 3 FORTIFY Maintenance Trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00466-4/fulltext
A37 Efficacy and Safety of Risankizumab as Maintenance Therapy in Patients With Crohn's Disease: 52 Week Results From the Phase 3 Fortify Study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8859234/
Th17 Cells in Inflammatory Bowel Disease: Cytokines, Plasticity, and Therapies https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7846404
Expansion of IL-23 Receptor Bearing TNFR2+ T Cells Is Associated With Molecular Resistance to Anti-TNF Therapy in Crohn's Disease https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6580782/
Comparative Efficacy and Safety of Biologic Therapies for Moderate-to-Severe Crohn's Disease: A Systematic Review and Network Meta-analysis https://linkinghub.elsevier.com/retrieve/pii/S2468-1253(21)00312-5
European Crohn's and Colitis Organisation https://www.ecco-ibd.eu/
Mercaptopurine Therapy and TPMT and NUDT15 Genotype https://www.ncbi.nlm.nih.gov/books/NBK100660/
Previous Episode

How Physicians Can Help Patients With Crohn's Disease Navigate Insurance Delays and Denials
Drs Peter Higgins and Frank Scott discuss the challenges of delays in care for patients with Crohn's disease, how insurance denials and delays harm patients, and what doctors can do to help.
Relevant disclosures can be found with the episode show notes on Medscape.com (https://www.medscape.com/viewarticle/967624). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.
Resources
Specialty Drug Coverage Varies Across Commercial Health Plans in the US https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2017.1553
2021 AMA Prior Authorization (PA) Physician Survey https://www.ama-assn.org/system/files/prior-authorization-survey.pdf
Corticosteroid Use and Complications in a US Inflammatory Bowel Disease Cohort https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4918923/
Increased Risk of Venous Thromboembolic Events With Corticosteroid vs Biologic Therapy for Inflammatory Bowel Disease https://www.cghjournal.org/article/S1542-3565(14)01045-3/fulltext
Impact of Prior Authorization of Antiepileptic Drugs in Children With Epilepsy https://www.pedneur.com/article/S0887-8994(18)30151-6/fulltext
Prior Authorization Delays Biologic Initiation and Is Associated With a Risk of Asthma Exacerbations https://pubmed.ncbi.nlm.nih.gov/33404389/
Treatment Delays Associated With Prior Authorization for Infusible Medications: A Cohort Study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7062557/
Delays Related to Prior Authorization in Inflammatory Bowel Disease https://publications.aap.org/pediatrics/article/149/3/e2021052501/184867/Delays-Related-to-Prior-Authorization-in
What Is the Role of Fecal Calprotectin Levels in the Diagnosis of Inflammatory Bowel Disease (IBD)? https://www.medscape.com/answers/179037-54913/what-is-the-role-of-fecal-calprotectin-levels-in-the-diagnosis-of-inflammatory-bowel-disease-ibd
Variation In Use and Content of Prescription Drug Step Therapy Protocols, Within and Across Health Plans https://www.healthaffairs.org/doi/10.1377/hlthaff.2021.00822?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
What Is Step Therapy/Fail First? https://www.crohnscolitisfoundation.org/get-involved/be-an-advocate/steptherapy
H.R. 2163 – Safe Step Act https://www.congress.gov/bill/117th-congress/house-bill/2163
Step Therapy's Balancing Act — Protecting Patients While Addressing High Drug Prices https://www.nejm.org/doi/10.1056/NEJMp2117582?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
Battle Heats up Over Bill on "Step Therapy," Drug Rebates https://www.coloradopolitics.com/legislature/battle-heats-up-over-bill-on-step-therapy-drug-rebates/article_0f6e56c4-c0b8-11ec-9ead-47fa6f99ac6e.html
Crohn Disease Pathology https://emedicine.medscape.com/article/1986158-overview#a6
Next Episode

Breaking the Therapeutic Ceiling in Crohn's Disease
Drs Peter Higgins and Bram Verstockt discuss breaking the therapeutic ceiling in Crohn's disease and the differential effectiveness of therapies and phenotypes in identifying responses to treatment.
Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/967626). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.
Resources
Crohn's Disease https://emedicine.medscape.com/article/172940-overview
A Blood-Based Prognostic Biomarker in IBD https://gut.bmj.com/content/68/8/1386
Role of the IL23/IL17 Pathway in Crohn's Disease https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8042267/
A Study of Efficacy and Safety of Combination Therapy With Guselkumab and Golimumab in Participants With Moderately to Severely Active Ulcerative Colitis (VEGA) https://clinicaltrials.gov/ct2/show/NCT03662542
Results of Novel Clinical Study Show Adults With Moderately to Severely Active Ulcerative Colitis Achieved Higher Rates of Clinical Response, Clinical Remission, and Endoscopic Improvement at 12 Weeks With Guselkumab and Golimumab Combination Therapy Versus Either Monotherapy Alone https://www.prnewswire.com/news-releases/results-of-novel-clinical-study-show-adults-with-moderately-to-severely-active-ulcerative-colitis-achieved-higher-rates-of-clinical-response-clinical-remission-and-endoscopic-improvement-at-12-weeks-with-guselkumab-and-golimumab-301486054.html
Digestive Disease Week 2022 https://ddw.org/
Triple Combination Therapy in High Risk Crohn's Disease (CD) https://clinicaltrials.gov/ct2/show/NCT02764762
Anti-TNF and Crohn's Disease: When Should We Stop? http://www.eurekaselect.com/article/15866
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