Ustekinumab for Peristomal Pyoderma Gangrenosum

Effective Strategies for the Management of Pyoderma Gangrenosum: A Comprehensive Review

“…Although ustekinumab has not been well characterized in PG, two case reports have demonstrated elevated expression of IL-23 in recalcitrant PG lesions. Furthermore, investigators have demonstrated the effectiveness of ustekinumab in the management of two PG patients and the medication has shown success in other neutrophilic disorders (97)(98)(99). Other biologics such as ixekizumab (anti-IL-17) and brodalumab (anti-IL-17R) will likely be effective in treating PG, given their theoretical ability to block IL-17-dependent neutrophil migration (96) but they have yet to be tested.…”

Pathophysiology of pyoderma gangrenosum (PG): An updated review

“…61 Ustekinumab, a human monoclonal antibody that targets the p40 subunit of IL-12 and IL-23, has been used successfully used in a few cases of PG. 60,[62][63][64] Defects in the JAK-STAT pathway result in inflammatory and myeloproliferative disorders. 17 Granulocyte colony-stimulating factor (G-CSF) activates this pathway, signaling neutrophil proliferation in areas of inflammation and injury.…”

Ustekinumab in treatment of Crohn’s disease: design, development, and potential place in therapy

“…This study identified that IL-17A expression was significantly stronger in patients requiring ustekinumab than in patients responding to topical therapy ( P =0.001) 73. Pyoderma gangrenosum (PG), including those recalcitrant to TNF antagonists and located in peristomal area, has been treated with ustekinumab 76–78. In a case report, the tissue sample from the PG lesion in the lower extremity showed a highly elevated expression of IL-23, and this patient was successfully treated with ustekinumab 78.…”