Safety and efficacy of an interleukin 12/23 inhibitor in a patient with constitutional neutropenia and psoriasis vulgaris

Starek, Jéssica Vianna; Bechara, Cristina Santos Ribeiro; Dultra, Mariana; Krakheche, Juliana de Morais Fernandes

doi:10.1016/j.abd.2020.11.010

Cited by 1 publication

(1 citation statement)

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“…They explained that Elevated IL-17 levels and IL-17-induced interferon (IFN)-γ and TNF-α overproduction may be involved in the pathogenesis of MDS and the number of CD3+ CD4+ IL-17 producing T cells (Th17) has been shown to markedly increase in low-risk MDS, UST inhibits the IL12/23 signaling pathway, leading to reduced Th17 responses (14).…”

Section: Case Presentationmentioning

confidence: 99%

Leukopenia that successfully treated by Ustekinumab in patient with psoriatic arthritis

Dumirieh,

Drie,

Haidar

et al. 2024

ijmsci

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Introduction:Psoriatic Arthritis (PsA) is an immune-mediated disease. The effectiveness of biologics has changed therapeutic strategies for psoriasis. We report a case of leukopenia in a patient with psoriatic arthritis (PsA) who was treated with Ustekinumab. Case presentation: A 36- year- old Syrian female presented for a follow up concerning treatment of psoriatic arthritis. She was diagnosed with psoriatic arthritis according to the CASPAR criteria. She was treated with Methotrexate, then Sulfasalazine. On presentation, the physical examination revealed tender in metacarpals, proximal interphalengal joints and distal interphalengal joints of both hands. Laboratory analysis showed: white blood cells (WBC) :3500 /mm3, (Neut:23% n = 40-65%, Lymp:65% n= 25-40%), erythrocyte sedimentation rate (ESR): 40 mm/h1, and C-reactive protein (CRP): 9.3 mg/L . Given the patient’s ongoing disease activity, and the presence of leukopenia, we started with Ustekinumab 45 mg subcutaneous. After the third dose of Ustekinumab, evaluation showed improvement in her peripheral arthritis and normal laboratory findings. Discussion: Patients with psoriasis had higher total white blood cell and neutrophil. Ustekinumab has good efficacy against disease activity as well as a favourable safety profile. In literature, we found a case of myelodysplastic syndrome associated with inflammatory bowel disease treated with Ustekinumab. Another case of constitutional neutropenia and psoriasis vulgaris treated with Ustekinumab. Conclusion: This is the first case of leukopenia associated with PsA successfully treated with Ustekinumab. UST treatment might be recommended for leukopenia associated with PsA, but further researches are recommended.

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Section: Case Presentationmentioning

confidence: 99%