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Japanese pediatric patient with moderately active ulcerative colitis successfully treated with ustekinumab: A case
Toshihiko Kakiuchi1, Masato Yoshiura
1Department of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan.
Insights
This study reports the first Japanese pediatric case of moderately active ulcerative colitis (UC) successfully treated with ustekinumab. Ustekinumab combined with steroids offers effective and safe induction therapy for pediatric UC.
Area of Science:
- Pediatric gastroenterology
- Immunomodulatory therapies
- Inflammatory bowel disease
Background:
- Ustekinumab is approved for adult Crohn disease and ulcerative colitis (UC).
- Limited data exist on ustekinumab's efficacy and safety in pediatric populations.
- No long-term data on ustekinumab for Japanese pediatric UC patients were available.
Observation:
- A 14-year-old male presented with moderately active total colitis-type UC (Pediatric UC Activity Index score of 50).
- The patient had steroid-resistant UC refractory to infliximab treatment.
- Ustekinumab was initiated alongside prednisolone at age 16.
Findings:
- The patient achieved and maintained remission of UC following ustekinumab treatment.
- No adverse side effects were reported during the treatment period.
Implications:
- Ustekinumab, in combination with steroids, represents a potentially effective and safe induction therapy for pediatric UC.
- This case highlights the potential of ustekinumab for managing refractory pediatric UC in Japan.
- Further research is warranted to confirm long-term efficacy and safety in pediatric UC.
Rationale:
Ustekinumab is effective in the treatment of adult Crohn disease (CD) and ulcerative colitis (UC). However, data on its efficacy and safety in pediatric CD and UC are limited. To the best of our knowledge, there are no reports of Japanese children with UC treated with ustekinumab in the long-term.
Patient Concerns:
A 14-year-old man with diarrhea and bloody stools was referred to our hospital. Colonoscopy revealed total colitis-type UC. His pediatric UC activity index score was 50, indicating moderately active UC.
Diagnoses:
Ulcerative colitis.
Interventions:
Infliximab was introduced because of steroid-resistant refractory UC; however, secondary ineffectiveness was observed 17 months later. Therefore, ustekinumab was administered along with prednisolone (16 years of age).
Outcomes:
The patient achieved UC remission after ustekinumab treatment, leading to maintained remission without side effects.
Lessons:
To the best of our knowledge, this is the first pediatric case of moderately active UC successfully treated with ustekinumab in Japan. Ustekinumab combined with steroids is an effective and safe induction therapy for UC.
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