Multicenter study of continuing ustekinumab after intravenous induction reactions in pediatric Crohn's disease

Reactions to intravenous ustekinumab for inflammatory bowel disease (IBD) occur, the frequency of which is uncertain. It is unclear how often subcutaneous treatment is continued after reactions to the intravenous dose, or how well it is tolerated. We therefore conducted a retrospective cohort study of pediatric patients who initiated ustekinumab for Crohn's disease from 6 pediatric IBD centers in the United States. Ten of 207 (5%) patients had an infusion reaction to their induction ustekinumab dose. Of these, 6 (60%) restarted their infusion, five completed the infusion. Subsequently, eight patients were treated with subcutaneous ustekinumab, none of whom develop reactions. Reaction to intravenous induction ustekinumab occurs in 5% of patients. Subcutaneous ustekinumab is generally well tolerated after intravenous reaction.