Inflammatory Bowel Diseases Center, Division of Gastroenterology, John T. Milliken Department of Medicine, Washington University School of Medicine, 600 South Euclid Avenue, Campus Box 8124 Saint Louis, MO 63110, USA.
Inflammatory Bowel Diseases Center, Division of Gastroenterology, Department of Medicine, University of California San Diego, 9500 Gilman Drive, MC 0956, La Jolla, CA 92093, USA. Electronic address: email@example.com.
This article reviews the available data regarding the efficacy of ustekinumab across published randomized clinical trials and open-label experience from tertiary medical centers, safety data, including in pregnancy, and its use in patients who have failed tumor necrosis factor (TNF) antagonists as well as patients who have not failed TNF antagonists. We have proposed an algorithm for positioning the use of ustekinumab among other agents (TNF antagonists, vedolizumab) in moderate-severe Crohn's disease. The article also enumerates drugs that are specific interleukin-23 blockers, including brazikumab (MEDI2070), risankizumab, LY3074828, tildrakizumab, and guselkumab, and the current status of their clinical trials.