{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T15:52:14Z","timestamp":1783698734221,"version":"3.55.0"},"reference-count":22,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therap Adv Gastroenterol"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Unlike infliximab, ustekinumab (UST) has shown inconsistent associations between drug concentration and clinical efficacy across studies, with varying cutoff therapeutic trough levels (TLs) proposed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>Given that patients have different histories of biologic use, we aimed to evaluate whether therapeutic TLs of ustekinumab require optimization in patients with Crohn\u2019s disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>To assess whether ustekinumab has a potential therapeutic cutoff value, we evaluated and compared its 1-year TLs in 14 biologic-na\u00efve patients and in 26 patients who were prescribed the drug after experiencing a loss of response to previous biologic therapies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The mean TL in the biologic-na\u00efve patients was 3.41\u2009\u00b5g\/mL, which was significantly higher than that in the biologic-experienced patients (1.46\u2009\u00b5g\/mL;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.007). The duration of prior biologic therapy and disease activity correlated with the ustekinumab TLs. With regard to the optimal cutoff value for predicting deep remission at 1\u2009year, the threshold was 2.34\u2009\u00b5g\/mL for the biologic-na\u00efve patients (area under the receiver operating characteristic curve (AUC)\u2009=\u20090.909,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and 1.18\u2009\u00b5g\/mL for the biologic-experienced patients (AUC\u2009=\u20090.892,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Ustekinumab TLs in patients may differ according to their prior exposure to biologic agents and disease activity. Accordingly, rather than applying a uniform threshold, ustekinumab levels should be interpreted using individualized, patient-specific strategies in clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17562848251393074","type":"journal-article","created":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T11:05:38Z","timestamp":1763204738000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Toward personalized therapeutic drug monitoring of ustekinumab in Crohn\u2019s disease: influence of previous exposure to biologics"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5600-2070","authenticated-orcid":false,"given":"Yiyoung","family":"Kwon","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1568-3364","authenticated-orcid":false,"given":"Yoon Zi","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae Jong","family":"Jeong","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6433-0242","authenticated-orcid":false,"given":"Seon Young","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hansol","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pusan National University Children\u2019s Hospital, Pusan National College of Medicine, Yangsan, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2012-9867","authenticated-orcid":false,"given":"Eun Sil","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yon Ho","family":"Choe","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4505-4083","authenticated-orcid":false,"given":"Mi Jin","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,15]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v28.i28.3666"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/MIB.0000000000000202"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2008.88"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-018-0084-8"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.02.031"},{"key":"e_1_3_4_7_2","first-page":"110","article-title":"Association between ustekinumab trough concentrations and biochemical outcomes in patients with Crohn\u2019s disease. A real life study","volume":"113","author":"Esp\u00edn RG","year":"2021","unstructured":"Esp\u00edn RG, De Prado IN, Candel MG, et al. Association between ustekinumab trough concentrations and biochemical outcomes in patients with Crohn\u2019s disease. A real life study. Rev Esp Enferm Dig 2021; 113: 110\u2013115.","journal-title":"Rev Esp Enferm Dig"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-021-07173-1"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2021.12.020"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/ibd\/izac030"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-021-01946-8"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2017.03.032"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/FTD.0000000000000976"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/ibd\/izad065"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"e_1_3_4_16_2","article-title":"Defining and validating cut-offs for the simple endoscopic score for Crohn\u2019s disease","volume":"132","author":"Moskovitz DN","year":"2007","unstructured":"Moskovitz DN, Daperno M, Baert F, et al. Defining and validating cut-offs for the simple endoscopic score for Crohn\u2019s disease. 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