Ustekinumab or vedolizumab for refractory metastatic Crohn's disease?
Year 2024,
Volume: 23 Issue: 1, 28 - 31, 25.04.2024
İdris Kurt
,
Hüseyin Ahmet Tezel
Abstract
Metastatic Crohn's disease is a rare skin manifestation of Crohn’s disease. A variety of treatment options are available for this condition. But there is a lack of clarity regarding the treatment of resistant cases. There is ongoing debate as to which agent should be selected (vedolizumab or ustekinumab) in patients that are not responding to anti-tumor necrosis factor agents. This study identifies a unique patient who has developed a disease (metastatic Crohn's disease) under treatment with vedolizumab. Following treatment with ustekinumab, the patient regressed completely. Therefore, we recommend ustekinumab primarily in metastatic Crohn's disease.
References
- 1. Siroy A, Wasman J. Metastatic Crohn disease: a rare cutaneous entity. Arch Pathol Lab Med. 2012;136(3):329-32.
- 2. Parks AG, Morson BC, Pegum JS. Crohn's disease with cutaneous involvement. Proc R Soc Med. 1965;58(4):241-2.
- 3. Bender-Heine A, Grantham JT, Zaslau S, Jansen R. Metastatic Crohn disease: a review of dermatologic manifestations and treatment. Cutis. 2017;99(6):E33-E40.
- 4. Vavricka SR, Brun L, Ballabeni P, et al. Frequency and risk factors for extraintestinal manifestations in the Swiss inflammatory bowel disease cohort. Am J Gastroenterol. 2011;106(1):110-9.
- 5. Teixeira M, Machado S, Lago P, Sanches M, Selores M. Cutaneous Crohn's disease. Int J Dermatol. 2006;45(9):1074-6.
- 6. Aberumand B, Howard J, Howard J. Metastatic Crohn's Disease: An Approach to an Uncommon but Important Cutaneous Disorder. Biomed Res Int. 2017;2017:8192150.
- 7. Phillips FM, Verstockt B, Sebastian S, et al. Inflammatory Cutaneous Lesions in Inflammatory Bowel Disease Treated With Vedolizumab or Ustekinumab: An ECCO CONFER Multicentre Case Series. J Crohns Colitis. 2020;14(10):1488-93.
- 8. Costa Blasco M, McFeely O, Doyle C, et al. Metastatic Crohn's Disease Improving with Vedolizumab [published online ahead of print, 2023 Mar 23]. Br J Dermatol. 2023;189(2):e35.
- 9. Wu J, Smogorzewski J. Ustekinumab for the treatment of paradoxical skin reactions and cutaneous manifestations of inflammatory bowel diseases. Dermatol Ther. 2021;34(3):e14883.
- 10. Ballester Sánchez R, Sanchís Sánchez C, Rodrigo Nicolás B, Valcuende Cavero F. Metastatic Crohn Disease Treated With Ustekinumab. Enfermedad de Crohn metastásica tratada con ustekinumab. Actas Dermosifiliogr (Engl Ed). 2021;112(2):182-3.
- 11. Lim Y, Singh M. Metastatic Vulval Crohn's Disease With Good Outcome on Ustekinumab. Cureus. 2021;13(7):e16252.
- 12. Blasco Alonso J, Girón Fernández-Crehuet F, Lendínez Ramírez MA, et al. Metastatic Crohn's disease in pediatrics. Rev Esp Enferm Dig. 2016;108(9):598-603.
- 13. Xiao TL, Ezenwa E, Ruiz de Luzuriaga A, Hoffman MD. Refractory metastatic Crohn's disease responsive to ustekinumab dose intensification. JAAD Case Rep. 2022;32:65-7.
- 14. Zullow S, Lichtman MK, Larson A, et al. Case series: ustekinumab use in metastatic cutaneous crohn's disease: 1998. Am J Gastroenterol 2017;112(Suppl 1):S1102.
Refrakter metastatik Crohn hastalığında ustekinumab veya vedolizumab?
Year 2024,
Volume: 23 Issue: 1, 28 - 31, 25.04.2024
İdris Kurt
,
Hüseyin Ahmet Tezel
Abstract
Metastatik Crohn hastalığı, Crohn hastalığının nadir görülen deri tutulumudur. Bu tutulum için çeşitli tedavi seçenekleri mevcuttur. Ancak dirençli vakaların tedavisi konusunda netlik yoktur. Anti-tümör nekrozis faktör ajanlara yanıt vermeyen hastalarda hangi ajanın (vedolizumab veya ustekinumab) seçilmesi konusunda tartışmalar devam etmektedir. Bu çalışmada, vedolizumab tedavisi altında iken hastalık (metastatik Crohn hastalığı) gelişen benzersiz bir hasta tarif etmekteyiz. Ustekinumab tedavisi sonrası hastalık tamamen geriledi. Bu nedenle metastatik Crohn hastalığında öncelikle ustekinumab tedavisini önermekteyiz.
References
- 1. Siroy A, Wasman J. Metastatic Crohn disease: a rare cutaneous entity. Arch Pathol Lab Med. 2012;136(3):329-32.
- 2. Parks AG, Morson BC, Pegum JS. Crohn's disease with cutaneous involvement. Proc R Soc Med. 1965;58(4):241-2.
- 3. Bender-Heine A, Grantham JT, Zaslau S, Jansen R. Metastatic Crohn disease: a review of dermatologic manifestations and treatment. Cutis. 2017;99(6):E33-E40.
- 4. Vavricka SR, Brun L, Ballabeni P, et al. Frequency and risk factors for extraintestinal manifestations in the Swiss inflammatory bowel disease cohort. Am J Gastroenterol. 2011;106(1):110-9.
- 5. Teixeira M, Machado S, Lago P, Sanches M, Selores M. Cutaneous Crohn's disease. Int J Dermatol. 2006;45(9):1074-6.
- 6. Aberumand B, Howard J, Howard J. Metastatic Crohn's Disease: An Approach to an Uncommon but Important Cutaneous Disorder. Biomed Res Int. 2017;2017:8192150.
- 7. Phillips FM, Verstockt B, Sebastian S, et al. Inflammatory Cutaneous Lesions in Inflammatory Bowel Disease Treated With Vedolizumab or Ustekinumab: An ECCO CONFER Multicentre Case Series. J Crohns Colitis. 2020;14(10):1488-93.
- 8. Costa Blasco M, McFeely O, Doyle C, et al. Metastatic Crohn's Disease Improving with Vedolizumab [published online ahead of print, 2023 Mar 23]. Br J Dermatol. 2023;189(2):e35.
- 9. Wu J, Smogorzewski J. Ustekinumab for the treatment of paradoxical skin reactions and cutaneous manifestations of inflammatory bowel diseases. Dermatol Ther. 2021;34(3):e14883.
- 10. Ballester Sánchez R, Sanchís Sánchez C, Rodrigo Nicolás B, Valcuende Cavero F. Metastatic Crohn Disease Treated With Ustekinumab. Enfermedad de Crohn metastásica tratada con ustekinumab. Actas Dermosifiliogr (Engl Ed). 2021;112(2):182-3.
- 11. Lim Y, Singh M. Metastatic Vulval Crohn's Disease With Good Outcome on Ustekinumab. Cureus. 2021;13(7):e16252.
- 12. Blasco Alonso J, Girón Fernández-Crehuet F, Lendínez Ramírez MA, et al. Metastatic Crohn's disease in pediatrics. Rev Esp Enferm Dig. 2016;108(9):598-603.
- 13. Xiao TL, Ezenwa E, Ruiz de Luzuriaga A, Hoffman MD. Refractory metastatic Crohn's disease responsive to ustekinumab dose intensification. JAAD Case Rep. 2022;32:65-7.
- 14. Zullow S, Lichtman MK, Larson A, et al. Case series: ustekinumab use in metastatic cutaneous crohn's disease: 1998. Am J Gastroenterol 2017;112(Suppl 1):S1102.