Alternative uses of ustekinumab for non-indicated dermatological conditions: a systematic review

Rawal, Sahil; Kianian, Sara; Guo, William; Marquez, Jocellie; Ayasse, Marissa; Siamas, Katherine; Lee, Yoojin; Salvemini, Joann

doi:10.1007/s00403-021-02262-7

Cited by 7 publications

(6 citation statements)

References 79 publications

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“…2,3 Ustekinumab has been used in children suffering from inflammatory bowel disease and CARD14-associated papulosquamous eruption (CAPE). 4 We present the use of an anti-interleukin 12/23 monoclonal antibody therapy in combination with acitretin for the effective treatment of pediatric PRP. In line with other anecdotal reports, ustekinumab proved effective and tolerable in the treatment of refractory PRP.…”

Section: Discussionmentioning

confidence: 99%

Successful treatment of a child's pityriasis rubra pilaris (PRP) with ustekinumab and acitretin

Medek

Selhofer

Matthias

et al. 2022

Pediatric Dermatology

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Pityriasis rubra pilaris (PRP) is a rare inflammatory skin disease that occurs with phenotypic variability in adults of all ages as well as in children. Data on the treatment of PRP is limited. Here, we report a 5‐year‐old girl with widespread skin involvement and prominent palmoplantar hyperkeratosis who was initially treated for psoriasis. After reevaluation, a diagnosis of PRP was made, and the patient had an excellent therapeutic response to ustekinumab and acitretin.

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Section: Discussionmentioning

confidence: 99%

Successful treatment of a child's pityriasis rubra pilaris (PRP) with ustekinumab and acitretin

Medek

Selhofer

Matthias

et al. 2022

Pediatric Dermatology

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“…Here we report on the efficacy and safety of ustekinumab in three patients with NS. Ustekinumab is a monoclonal antibody targeting the p40 subunit of IL‐12 and IL‐23 which has been shown to be highly effective in psoriasis, psoriatic arthritis and other inflammatory skin diseases 21 . The rationale for targeting the IL‐23/IL‐17 axis in NS stems from a previous report showing IL‐17 skewing in ichthyosis patients and NS in particular 12 .…”

Section: Discussionmentioning

confidence: 99%

“…Ustekinumab is a monoclonal antibody targeting the p40 subunit of IL-12 and IL-23 which has been shown to be highly effective in psoriasis, psoriatic arthritis and other inflammatory skin diseases. 21 The rationale for targeting the IL-23/IL-17 axis in NS stems from a previous report showing IL-17 skewing in ichthyosis patients and NS in particular. 12 Moreover, NS patients demonstrate high levels of IL-19, which is induced by both Th17 and Th2 cytokines and in turn amplifies IL-17 effects in keratinocytes.…”

Section: Con Clus Ionsmentioning

confidence: 99%

Ustekinumab therapy for Netherton syndrome

Samuelov

Shehadeh

Sarig

et al. 2022

The Journal of Dermatology

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Netherton syndrome (NS) is a rare disorder of cornification associated with high morbidity. It is caused by bi‐allelic mutations in SPINK5 encoding the serine protease inhibitor LEKTI. Previous studies have shown Th17 skewing with IL‐23 upregulation in NS, raising the possibility that targeting these inflammatory pathways may alleviate disease manifestations. We ascertained the therapeutic efficacy of six doses of ustekinumab administered to three patients with NS over a period of 13 months using the Ichthyosis Area and Severity Index (IASI), the Dermatology Life Quality Index (DLQI), a visual analogue scale (VAS) for itch and the peak‐pruritus numeric rating scale (PP‐NRS). Histopathology analysis including CD3, CD4, CD8 and interleukin 17 (IL‐17) immunostaining, was performed at baseline and 4 weeks following the last ustekinumab dose. Total IASI scores were reduced by 28% in two patients at week 16 with sustained response by week 56. No consistent improvement in DLQI, VAS for itch and PP‐NRS scores was observed. The inflammatory infiltrate and the degree of acanthosis were slightly reduced at week 56 as compared to baseline. No significant change in immunostaining of the various inflammatory markers was observed at week 56. In conclusion, this case series did not demonstrate a significant therapeutic effect of ustekinumab in NS.

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“…Aside from these labeled indications, ustekinumab has been used "off-label" for other inflammatory diseases. 6 However, while multiple publications, mainly case reports and a small number of case series, have shown excellent results of ustekinumab when prescribed off-label for treatment of various skin conditions, there is a lack of a systemic reviews in the literature. Hence, in this review we discuss ustekinumab's pharmacological effects, efficacy, and safety in the treatment of psoriasis.…”

Section: Introductionmentioning

confidence: 99%

Ustekinumab in Dermatology: Approved Indications and Off-label Uses

Chehad¹,

Boutrid²,

Rahmoune³

2023

J Explor Res Pharmacol

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Ustekinumab is a human antibody that interacts with the p40 chain shared by both interleukin (IL)-12 and IL-23. Treatment with usterkinumab can effectively inactivate the biological functions of IL-12 and IL-23 to control aberrant Th1 and Th17 immunological responses. Ustekinumab is the first unique IL-12/IL-23 blocker approved by the Food and Drug Administration for the treatment of patients with moderate or severe psoriasis. Subsequently, its application has extended as a therapeutic option for psoriatic arthritis and inflammatory bowel diseases. Given its therapeutic mechanism, usterkinumab may be used as a potential alternative for treatment of a variety of inflammatory skin conditions. More importantly, usterkinumab is relatively safe, as the associated adverse reactions are generally non-serious and rare; although continuous monitoring of its adverse events is warranted. Here, we discuss the therapeutic effects of ustekinumab and its clinical applications specifically in dermatology.

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Alternative uses of ustekinumab for non-indicated dermatological conditions: a systematic review

Cited by 7 publications

References 79 publications

Successful treatment of a child's pityriasis rubra pilaris (PRP) with ustekinumab and acitretin

Successful treatment of a child's pityriasis rubra pilaris (PRP) with ustekinumab and acitretin

Ustekinumab therapy for Netherton syndrome

Ustekinumab in Dermatology: Approved Indications and Off-label Uses

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