Ustekinumab in the management of Crohn’s disease: Expert opinion

Armuzzi, Alessandro; Ardizzone, Sandro; Biancone, Livia; Castiglione, Fabiana; Danese, Silvio; Gionchetti, Paolo; Orlando, Ambrogio; Rizzello, Fernando; Scribano, Maria Lia; Vecchi, Maurizio

doi:10.1016/j.dld.2018.02.017

Cited by 22 publications

(14 citation statements)

References 65 publications

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“…Ustekinumab is a laboratory-manufactured IgG1κ monoclonal antibody representing an interesting new therapeutic option for the treatment of patients with CD that are refractory or intolerant to either conventional treatments or anti-TNF agents. It targets the p40 subunit shared by two proinflammatory cytokines, IL-12 and IL-23, thereby preventing their interaction with the receptor and blocking subsequent signaling (24)(25)(26). Vedolizumab is also a monoclonal IgG-1 anti-body, with activity as an α4β7 integrin heterodimer antagonist.…”

Section: Discussionmentioning

confidence: 99%

Metastatic vulvar Crohn’s disease preceding intestinal manifestations: a case report and short review

Kyriakou¹,

Gkermpesi²,

Thomopoulos³

et al. 2019

Acta Dermatovenerologica Alpina Pannonica Et Adriatica

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Crohn's disease (CD) is a multi-systemic chronic granulomatous inflammatory disease with a constellation of extraintestinal manifestations affecting various organs, including the skin. Metastatic CD (MCD), defined as granulomatous lesions of the skin occurring at sites separate from the gastrointestinal (GI) tract in patients affected with CD, is the least common cutaneous manifestation, and it is occasionally the primary manifestation of the disease. It may precede any symptoms from the GI tract by months or even years, and it often remains undiagnosed. We present the case of a 42-year-old woman with a rare cutaneous manifestation of MCD involving the external genitalia. The cutaneous lesions of the mons pubis and vulva preceded GI manifestations of CD by 2 years. The patient was treated with azathioprine, oral steroids, and antibiotics. Reduction of the cutaneous nodules, discharge, and erythema was achieved, accompanied by relief of GI symptoms. Response to treatment was maintained during a follow-up of 6 months. In MCD, involvement of the external genitalia is exceedingly rare, with few documented cases in the literature. The integration of clinical information, microscopic findings, and exclusion of other cutaneous granulomatous processes is necessary in order to accurately diagnose this rare dermatologic entity and provide an opportunity for successful therapeutic intervention.

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Section: Discussionmentioning

confidence: 99%

Metastatic vulvar Crohn’s disease preceding intestinal manifestations: a case report and short review

Kyriakou¹,

Gkermpesi²,

Thomopoulos³

et al. 2019

Acta Dermatovenerologica Alpina Pannonica Et Adriatica

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“…Ustekinumab is a monoclonal antibody with a peculiar mechanism of action, blocking the activities of interleukin‐12 and interleukin‐23 (Buggiani et al, ), used in the treatment of various diseases such as Psoriasis and recently used in CD: it appears to be associated with rapid and sustained clinical effect, as reported from the clinical research program, with additional support for potential mucosal healing (Armuzzi et al, ). Some studies have emphasized link between psoriasis and CD focusing on IL 12‐23 dysregulation.…”

Section: Discussionmentioning

confidence: 99%

Anti‐interleukin 12/23 in the treatment of erythema nodosum and Crohn disease: A case report

Spagnuolo

Dastoli

Silvestri

et al. 2019

Dermatologic Therapy

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“…However, tofacitinib was not prescribed in this patient due to her insurance policy's limitation.Ustekinumab is indicated for the treatment of adult patients (>18 years old), and those who have failed or become intolerant to immunomodulators (steroids, or anti-tumor necrosis factor (TNFα)). Ustekinumab appears to have a swift and lasting effect with potential for mucosal healing and systemic anti-inflammatory response with no known immunogenicity [8][9][10][11], in contrast to TNFα blockers. Ustekinumab may be preferred over anti-TNF therapy in older patients with increased risk for infections and malignancy, as concurrent immunosuppression may not be required due to its low immunogenicity [12].…”

Section: Discussionmentioning

confidence: 99%

Rapid Induction and Maintenance of Remission in Refractory Ulcerative Colitis with Ustekinumab

Chen

2019

Diseases

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Ulcerative colitis is a chronic debilitating disease characterized by relapsing in intestinal inflammation and ulcers with no available cure. This is a clinical case report of a 52-year-old female patient with 30 years history of left-sided chronic ulcerative colitis controlled with standard of care (mesalamine and azathioprine) which subsequently relapsed and developed into active refractory ulcerative colitis. The patient became unresponsive to her medications including different forms of mesalamines and did not respond favorably to any of the other current therapies. Numerous attempts to stabilize her condition with immunosuppressants, steroids, probiotics, antibiotics, mesalamines, and various biologic agents failed to improve her clinical symptoms, and the patient was being considered for colectomy. As the last resort, modified therapy was prescribed with ustekinumab, a non-selective, anti-IL12/23 p40 monoclonal antibody. This medication has not been yet approved for use in ulcerative colitis patients. In this clinical case we report the efficacy of ustekinumab to rapidly induce and maintain remission of the severe chronic ulcerative colitis in the patient. To the best of our knowledge, this is the first report of utilizing ustakinamub therapy for rapid induction in an active refractory ulcerative colitis patient resulting in complete remission for over one year.

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Ustekinumab in the management of Crohn’s disease: Expert opinion

Cited by 22 publications

References 65 publications

Metastatic vulvar Crohn’s disease preceding intestinal manifestations: a case report and short review

Metastatic vulvar Crohn’s disease preceding intestinal manifestations: a case report and short review

Anti‐interleukin 12/23 in the treatment of erythema nodosum and Crohn disease: A case report

Rapid Induction and Maintenance of Remission in Refractory Ulcerative Colitis with Ustekinumab

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