RESUMO
El tratamiento con farmacos antifactor de necrosis tumoral alfa (TNF-¦Á) en la enfermedad de Crohn es relativamente seguro aunque se han comunicado diferentes efectos secundarios cutaneos como la aparicion o exacerbacion de una psoriasis secundaria al tratamiento con anti-TNF-¦Á que, en ocasiones, puede llevar a la suspension del tratamiento. Por ello, son necesarias nuevas alternativas terapeuticas con nuevos mecanismos de accion. Se ha publicado que ustekinumab, un anticuerpo monoclonal que se une a la subunidad p40 de la interleucina 12/23, podrea inducir repuesta en pacientes con enfermedad de Crohn y ademas ha demostrado su eficacia en pacientes con psoriasis. Presentamos un caso de una paciente con enfermedad de Crohn que desarrollo psoriasis tras el tratamiento con 2 farmacos anti-TNF-¦Á (infliximab y adalimumab) que fue posteriormente tratada con ustekinumab con resolucion de las lesiones de la psoriasis y mantuvo la remision de la enfermedad de Crohn (AU)
Treatment with anti-tumor necrosis factor (TNF)-¦Á for Crohn's disease is relatively safe, although various cutaneous adverse effects have been reported such as the development or exacerbation of anti-TNF- ¦Á-induced psoriasis, which can sometimes lead to treatment withdrawal. Therefore, new alternative treatments with new mechanisms of action are required. Ustekinumab, a monoclonal antibody against the p40 subunit of interleukin 12/23, could induce response in patients with Crohn's disease and has demonstrated efficacy in patients with psoriasis. We present the case of a woman with Crohn's disease who developed psoriasis after treatment with two anti-TNF- ¦Á drugs (infliximab and adalimumab). The patient was subsequently treated with ustekinumab with resolution or psoriasis lesions and maintenance of remission of Crohn's disease (AU)
Assuntos
Humanos , Doença de Crohn/tratamento farmacológico , Psoríase/induzido quimicamente , Anticorpos Monoclonais/farmacocinética , Doença de Crohn/complicações , Fator de Necrose Tumoral alfa/antagonistas & inibidoresRESUMO
Treatment with anti-tumor necrosis factor (TNF)-α for Crohn's disease is relatively safe, although various cutaneous adverse effects have been reported such as the development or exacerbation of anti-TNF- α-induced psoriasis, which can sometimes lead to treatment withdrawal. Therefore, new alternative treatments with new mechanisms of action are required. Ustekinumab, a monoclonal antibody against the p40 subunit of interleukin 12/23, could induce response in patients with Crohn's disease and has demonstrated efficacy in patients with psoriasis. We present the case of a woman with Crohn's disease who developed psoriasis after treatment with two anti-TNF- α drugs (infliximab and adalimumab). The patient was subsequently treated with ustekinumab with resolution or psoriasis lesions and maintenance of remission of Crohn's disease.
