Biyolojik Tedaviye Yanıtsız Ülseratif Kolit Hastalarında Ustekinumab Tedavi Persistansı: Tek Merkez Gerçek Yaşam Deneyimi

Öz

Ustekinumab, ülseratif kolit (ÜK) tedavisinde etkili bir biyolojik ajan olmakla birlikte, özellikle biyolojik tedavi deneyimli hastalarda tedavi persistansı ve bunu etkileyen faktörlere ilişkin gerçek yaşam verileri sınırlıdır. Bu retrospektif kohort çalışmada, Ocak 2021 ile Aralık 2025 tarihleri arasında ustekinumab tedavisi alan ülseratif kolit hastalarında tedavi persistansının değerlendirilmesi ve tedavi bırakmayı etkileyen faktörlerin belirlenmesi amaçlandı. Tedavi persistansı, tedavi başlangıcı ile kesilme arasındaki süre olarak tanımlandı ve Kaplan–Meier yöntemi ile analiz edildi. Çalışmaya toplam 42 biyolojik tedavi deneyimli hasta dahil edildi. On iki aylık ve 24 aylık tedavi persistansı sırasıyla %90,5 ve %85,7 olarak saptandı ve takip süresince hastaların %14,3’ünde tedavi kesilmesi gözlendi. Cerrahi öyküsü tedavi bırakma ile anlamlı ilişkili bulundu (p=0,026) ve bu hastalarda tedavi persistansının anlamlı derecede daha düşük olduğu görüldü (log-rank p<0,001). Kadın cinsiyet de daha düşük tedavi persistansı ile ilişkiliydi (log-rank p=0,045). Sigara kullanımı, hastalık yaygınlığı, önceki biyolojik tedavi öyküsü ve ekstraintestinal bulgular gibi diğer klinik değişkenler ile tedavi persistansı arasında anlamlı ilişki saptanmadı. Sonuç olarak, ustekinumabın biyolojik tedavi deneyimli ülseratif kolit hastalarında gerçek yaşam koşullarında yüksek tedavi persistansı ile ilişkili olduğu görülmüştür. Cerrahi öyküsü ve kadın cinsiyetin daha düşük tedavi persistansı ile ilişkili olabileceği düşünülmektedir. Bu bulguların daha geniş ve prospektif çalışmalarla doğrulanması gerekmektedir.

Anahtar Kelimeler

• Ülseratif kolit
• Ustekinumab
• Tedavi persistansı
• Biyolojik tedavi
• Gerçek yaşam verisi

Ustekinumab Treatment Persistence in Ulcerative Colitis Patients Unresponsive to Biologic Treatment: A Single-Center Real-World Experience

Öz

Ustekinumab is an effective biological agent for the treatment of ulcerative colitis (UC); however, real-world data on treatment persistence and factors affecting drug survival in biologic-experienced patients remain limited. This retrospective cohort study aimed to evaluate ustekinumab treatment persistence and identify factors associated with treatment discontinuation in UC patients treated between January 2021 and December 2025. Treatment persistence was defined as the time from treatment initiation to discontinuation and was analyzed using the Kaplan–Meier method. A total of 42 biologic-experienced UC patients were included. The 12-month and 24-month treatment persistence rates were 90.5% and 85.7%, respectively, and 14.3% of patients discontinued treatment during follow-up. Surgical history was significantly associated with higher treatment discontinuation rates (p=0.026), and patients with prior surgery had significantly lower treatment persistence (log-rank p<0.001). Female sex was also associated with lower treatment persistence (log-rank p=0.045). Other clinical variables, including smoking status, disease extent, prior biologic exposure, and extraintestinal manifestations, were not significantly associated with treatment persistence. In conclusion, ustekinumab demonstrates high treatment persistence in biologic-experienced UC patients in real-world practice, and surgical history and female sex may be associated with lower treatment persistence. Larger prospective studies are needed to confirm these findings.

Anahtar Kelimeler

• Ulcerative colitis
• Ustekinumab
• Treatment persistence
• Biologic therapy
• Real-world data

Kaynakça

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