Ustekinumab is effective and safe in the treatment of Crohn’s disease refractory to anti-TNFα in an orthotopic liver transplant patient

Martínez-Montiel, María Pilar; Piedracoba-Cadahia, Pilar; Gómez-Gómez, Carlos; Gonzalo, Juan Francisco

doi:10.1093/ecco-jcc/jjv109

Cited by 15 publications

(5 citation statements)

References 5 publications

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“…Martínez-Montiel et al have studied its use in a post-OLT patient in whom a favorable clinical course of CD was observed after TNF-ɑ inhibitors failed. 12 Similarly, the integrin α4β7 antagonist vedolizumab has been shown to be relatively safe in liver transplant patients in a study by Spadaccini et al, although caution is recommended in patients with unstable graft function. 13 Vedolizumab has been shown to be a safe and effective steroid-sparing therapy for the treatment of moderate to severe CD among liver transplant recipients.…”

Section: Discussionmentioning

confidence: 99%

Infliximab-Induced Acute Liver Failure in a Patient With Crohn's Disease Requiring Orthotopic Liver Transplantation

et al. 2021

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Tumor necrosis factor-alpha inhibitors are not known to have significant liver toxicity; however, a few case reports state otherwise. We report the case of a 25-year-old man with Crohn's disease who was initiated on infliximab. The patient developed severe mixed hepatocellular and cholestatic liver injury that progressed into acute liver failure. Based on clinical history, laboratory findings, and histology, this was presumed because of the development of autoimmune hepatitis secondary to infliximab. He underwent liver transplantation. The mainstay of treatment in this rare condition involves steroid therapy and possible transplantation. Patients must then avoid anti–tumor necrosis factor-alpha therapy for life.

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Section: Discussionmentioning

confidence: 99%

Infliximab-Induced Acute Liver Failure in a Patient With Crohn's Disease Requiring Orthotopic Liver Transplantation

et al. 2021

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“…There is one case of a liver transplant recipient treated with ustekinumab to manage CD with no reported adverse event after 12 months of follow-up. 82 Currently, there is no report of a transplant patient receiving ustekinumab for the treatment of psoriasis.…”

Section: Transplant Patientsmentioning

confidence: 99%

TNF-Alpha Inhibitors and Ustekinumab for the Treatment of Psoriasis: Therapeutic Utility in the Era of IL-17 and IL-23 Inhibitors

Hong

Hadeler

Mosca

et al. 2022

Journal of Psoriasis and Psoriatic Arthritis

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Psoriasis is a chronic inflammatory condition for which eleven FDA-approved biologic therapies are approved. Over the past decade, studies have documented the higher efficacy of IL-17 and IL-23 inhibitors for the treatment of psoriasis compared to the TNF-alpha inhibitors and ustekinumab, an IL-12/23 inhibitor. Despite this, there remains an important role for the use of TNF-alpha inhibitors and ustekinumab in the treatment of psoriasis. Here, we review how considerations of infection and malignancy risk, patient demographics, treatment resistance, and comorbidities may make certain TNF-alpha inhibitors or ustekinumab an excellent choice for therapy in particular patient subgroups.

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“…There is no published data on the use of IL‐23 inhibitors guselkumab, risankizumab, or tildrakizumab in solid organ transplant recipients. Two case reports were published highlighting the use of ustekinumab (IL‐12/IL‐23 inhibitor): a LT recipient 4 years post‐transplant on concomitant tacrolimus, azathioprine, and steroids and another LT recipient 16 years post‐transplant on concomitant tacrolimus 41,42 . Neither patient had infectious or graft complications at 9 and 12 months following ustekinumab initiation, respectively.…”

Section: Agentsmentioning

confidence: 99%

The use of non‐transplant biologics in solid organ transplant recipients: A practical review for the frontline clinician

Szczepanik

Choi

Brady

et al. 2022

Clinical Transplantation

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Biologics have become the forefront of medicine for management of autoimmune conditions, leading to improved quality of life. Many autoimmune conditions occur in solid organ transplant (SOT) recipients and persist following transplant. However, the use of biologics in this patient population is not well studied, and questions arise related to risk of infection and adjustments to induction and maintenance immunosuppression. Guidelines have been published highlighting management strategies of biologics around the time of elective surgical procedures, but this is not always feasible in urgent situations, especially with deceased donor transplantation. The aim of this review is to summarize the current literature regarding the use of these agents in solid organ transplant recipients, and specifically address induction and maintenance immunosuppression, as well as the need for alternative infective prevention strategies to create This paper represents the opinion of the Immunology/Transplantation Practice and Research Network of the American College of Clinical Pharmacy. It does not necessarily represent an official ACCP commentary, guideline, or statement of policy or position.

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Ustekinumab is effective and safe in the treatment of Crohn’s disease refractory to anti-TNFα in an orthotopic liver transplant patient

Cited by 15 publications

References 5 publications

Infliximab-Induced Acute Liver Failure in a Patient With Crohn's Disease Requiring Orthotopic Liver Transplantation

Infliximab-Induced Acute Liver Failure in a Patient With Crohn's Disease Requiring Orthotopic Liver Transplantation

TNF-Alpha Inhibitors and Ustekinumab for the Treatment of Psoriasis: Therapeutic Utility in the Era of IL-17 and IL-23 Inhibitors

The use of non‐transplant biologics in solid organ transplant recipients: A practical review for the frontline clinician

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