Tomáš Koller
In the recent decades it came to the revolution in the Crohn’s disease treatment. The implementation of the biological
treatment using TNF-alpha antibodies significantly improved the patients’ quality of life. However, the biological
treatment is not effective in each patient. Approximately the third of patients do not respond to this treatment
and another approximately 40% of patients lose the response to the biological treatment sooner or later. Therefore
there is a growing number of patients, in whom the treatment with presently available molecules was exhausted
and a demand originates for new therapeutical possibilities. Ustekinumab is a monoclonal antibody against a subunit
p40 of interleukin 12 and 23. At present it is registered for the treatment of skin psoriasis, psoriatic arthritis and
mild or severe Crohn’s disease. Nowadays, we have the evidence of the ustekinumab effectiveness in the treatment
of Crohn’s disease from the studies of the phase 2, from cohort observation studies of the refractory patients and
from recently published studies of the phase 3. Ustekinumab appears as an effective and safe drug able to improve
the course and to induce and maintain the remission of the active Crohn’s disease in patients in whom the previous
biological or conventional treatment was not successful.