Long‐term effects of ustekinumab in children with inflammatory bowel disease: A systematic review
Bibliographic record
Abstract
Ustekinumab, a monoclonal antibody used in adults, is increasingly employed in children and adolescents with refractory inflammatory bowel disease (IBD). This review aimed to analyze its long-term efficacy and safety in the pediatric population. To this end, a systematic review was registered under PROSPERO (CRD42024555896). Articles indexed in PubMed/Medline, Cochrane Library, and Web of Science up to May 30, 2024, were screened. Quality was assessed using the Newcastle-Ottawa Scale. From 563 articles, 11 observational studies were included, analyzing 444 pediatric IBD patients. Remission rates varied: 47% at Week 16, 57%-59% at Week 26, and 40%-64% at Week 52. In addition, clinical improvements included better Z-scores, body mass index, reduced inflammation, and healing of mucosal and perianal disease. Five studies standardized doses by weight: 260 mg (<55 kg), 390 mg (55-85 kg), and 520 mg (>85 kg), with maintenance doses typically 90 mg every 8-12 weeks. Some patients received concomitant therapies (e.g., methotrexate, corticosteroids, and 5-aminosalicylic acid). While adverse effects were reported, including worsening psoriasis, cutaneous and neurological reactions, infections, elevated transaminases, and lymphopenia. Severe adverse events were rare, though anaphylaxis and one death from acute diarrhea were reported. Overall, ustekinumab shows promising clinical and laboratory outcomes in pediatric IBD. However, long-term studies are essential to solidify evidence regarding remission rates and adverse effects.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.014 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.007 |
| Bibliometrics | 0.004 | 0.006 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".