Ustekinumab en la artritis psoriásica y la enfermedad de Crohn
Ustekinumab in Psoriatic Arthritis and Crohn Disease
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Otros usos. Otras formas de psoriasis. Otras patologías cutáneas" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "59" "paginaFinal" => "64" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Ustekinumab. Other uses. Other forms of psoriasis. Other skin conditions" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Sánchez-Regaña" "autores" => array:1 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Sánchez-Regaña" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731012700108?idApp=UINPBA000044" "url" => "/00017310/00000103000000S2/v1_201304241722/S0001731012700108/v1_201304241722/es/main.assets" ] "es" => array:12 [ "idiomaDefecto" => true "titulo" => "Ustekinumab en la artritis psoriásica y la enfermedad de Crohn" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "65" "paginaFinal" => "72" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "R. Queiro, D. Ginard" "autores" => array:2 [ 0 => array:4 [ "nombre" => "R." "apellidos" => "Queiro" "email" => array:1 [ 0 => "queiro@mixmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:4 [ "nombre" => "D." "apellidos" => "Ginard" "email" => array:1 [ 0 => "daniel.ginard@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Reumatología. Hospital Universitario Central de Asturias. Oviedo. Asturias. España" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Aparato Digestivo. Hospital Universitario Son Espases. Palma de Mallorca. Mallorca. España" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Autor para correspondencia." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Ustekinumab in Psoriatic Arthritis and Crohn Disease" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec85104" "palabras" => array:6 [ 0 => "Psoriasis" 1 => "Artritis psoriásica" 2 => "Ustekinumab" 3 => "Eficacia" 4 => "Enfermedad de Crohn" 5 => "Interleucina 12/23" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec85103" "palabras" => array:6 [ 0 => "Psoriasis" 1 => "Psoriatic arthritis" 2 => "Ustekinumab" 3 => "Efficacy" 4 => "Crohn disease" 5 => "Interleukin 12/23" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Aunque la indicación principal de ustekinumab (UST) en el momento actual es la psoriasis, su innovador mecanismo de acción aventura otras indicaciones en un futuro próximo, entre ellas, la artritis psoriásica (APs) y la enfermedad de Crohn (EC).</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">La psoriasis y la APs son entidades donde la interacción de elementos de restricción genética, junto a factores ambientales e inmunológicos juegan un papel clave para dar lugar a las manifestaciones propias de ambas enfermedades. Una de las principales vías patogénicas en estas condiciones es el eje IL-23/Th17, y existen sobradas evidencias para apoyar intervenciones farmacológicas sobre el mismo. En el momento actual, sólo disponemos de un agente con capacidad de actuar sobre esta diana, UST, un anticuerpo monoclonal humano frente a la subunidad común p40 de la IL-12 e IL-23. Aunque disponemos de cierta información sobre su utilidad en el tratamiento de la APs, aún precisamos de más datos sobre su eficacia y seguridad en este campo.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Por otra parte, la EC es una enfermedad inflamatoria crónica de etiología desconocida que afecta al tubo digestivo. El tratamiento consiste en el uso de corticoides, inmunosupresores y anticuerpos anti factor de necrosis tumoral. Algunos pacientes no responden, por lo que es necesario disponer de alternativas de tratamiento, entre las que se encuentra UST. Recientemente, dos estudios fase IIb apuntan a que UST induce y mantiene la respuesta clínica en la EC, principalmente en pacientes con fracaso previo a infliximab y proteína C reactiva elevada en el momento del tratamiento. Aún quedan interrogantes por resolver, como la dosis más eficaz o la vía de administración más adecuada, y se precisan más estudios para evaluar la eficacia y determinar el mejor esquema terapéutico en la EC.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El presente trabajo revisa la información disponible hasta la fecha sobre la utilidad potencial de este nuevo agente en el tratamiento de la APs y la EC.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Although ustekinumab is currently licensed for the treatment of psoriasis, in view of the innovative mechanism of action of this biologic agent, it is reasonable to hypothesize that it will, in the near future, be approved for other indications, such as the treatment of psoriatic arthritis and Crohn disease.</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Interactions between genetic, environmental, and immunological factors play a key role in the pathogenesis of both psoriasis and psoriatic arthritis. The IL-23/T<span class="elsevierStyleInf">H</span>17 axis is one of the main pathogenic pathways in these diseases, and there is ample evidence to support the use of pharmacologic agents targeting this pathway. Ustekinumab, a human monoclonal antibody that binds to the p40 subunit shared by IL-12 and IL-23, is currently the only agent capable of modulating the IL-23/T<span class="elsevierStyleInf">H</span>17 pathway. While there is some evidence supporting the use of ustekinumab in the treatment of psoriatic arthritis, more data on safety and efficacy are required.</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Crohn disease is a chronic inflammatory disease of unknown etiology that affects the digestive tract. It is treated with corticosteroids, immunosuppressants, and anti-TNF agents. Alternative treatments, such as ustekinumab, however, are needed for patients who do not respond to conventional therapy. The results of 2 recent phase IIb studies showed that ustekinumab induced and maintained clinical response in patients with Crohn disease; most of those who responded well had previously been unsuccessfully treated with infliximab and had elevated C reactive protein levels at the time of treatment. Many issues remain to be resolved, including the establishment of an optimal dose and administration route. Further studies are needed to evaluate the efficacy of ustekinumab in Crohn disease and to determine the best treatment regimen.</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The present chapter reviews the current evidence on the potential usefulness of ustekinumab in the treatment of psoriatic arthritis and Crohn disease.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:31 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 6 | 11 | 17 |
| 2024 October | 47 | 40 | 87 |
| 2024 September | 37 | 20 | 57 |
| 2024 August | 65 | 41 | 106 |
| 2024 July | 48 | 29 | 77 |
| 2024 June | 58 | 28 | 86 |
| 2024 May | 41 | 24 | 65 |
| 2024 April | 27 | 14 | 41 |
| 2024 March | 39 | 34 | 73 |
| 2024 February | 33 | 24 | 57 |
| 2024 January | 34 | 17 | 51 |
| 2023 December | 32 | 14 | 46 |
| 2023 November | 53 | 19 | 72 |
| 2023 October | 34 | 12 | 46 |
| 2023 September | 23 | 21 | 44 |
| 2023 August | 28 | 11 | 39 |
| 2023 July | 26 | 24 | 50 |
| 2023 June | 25 | 22 | 47 |
| 2023 May | 14 | 9 | 23 |
| 2023 April | 18 | 12 | 30 |
| 2023 March | 24 | 20 | 44 |
| 2023 February | 26 | 12 | 38 |
| 2023 January | 32 | 28 | 60 |
| 2022 December | 35 | 23 | 58 |
| 2022 November | 28 | 23 | 51 |
| 2022 October | 36 | 23 | 59 |
| 2022 September | 23 | 33 | 56 |
| 2022 August | 21 | 30 | 51 |
| 2022 July | 29 | 28 | 57 |
| 2022 June | 18 | 22 | 40 |
| 2022 May | 20 | 30 | 50 |
| 2022 April | 23 | 39 | 62 |
| 2022 March | 24 | 43 | 67 |
| 2022 February | 24 | 18 | 42 |
| 2022 January | 30 | 32 | 62 |
| 2021 December | 20 | 35 | 55 |
| 2021 November | 25 | 37 | 62 |
| 2021 October | 44 | 39 | 83 |
| 2021 September | 42 | 40 | 82 |
| 2021 August | 38 | 31 | 69 |
| 2021 July | 59 | 35 | 94 |
| 2021 June | 39 | 34 | 73 |
| 2021 May | 23 | 34 | 57 |
| 2021 April | 50 | 60 | 110 |
| 2021 March | 50 | 28 | 78 |
| 2021 February | 49 | 21 | 70 |
| 2021 January | 29 | 10 | 39 |
| 2020 December | 22 | 15 | 37 |
| 2020 November | 19 | 16 | 35 |
| 2020 October | 18 | 8 | 26 |
| 2020 September | 10 | 5 | 15 |
| 2020 August | 11 | 17 | 28 |
| 2020 July | 13 | 9 | 22 |
| 2020 June | 17 | 18 | 35 |
| 2020 May | 25 | 29 | 54 |
| 2020 April | 13 | 16 | 29 |
| 2020 March | 17 | 17 | 34 |
| 2020 February | 3 | 2 | 5 |
| 2020 January | 0 | 7 | 7 |
| 2019 December | 0 | 7 | 7 |
| 2019 November | 0 | 4 | 4 |
| 2019 October | 0 | 2 | 2 |
| 2019 September | 0 | 4 | 4 |
| 2019 August | 0 | 7 | 7 |
| 2019 July | 0 | 13 | 13 |
| 2019 June | 0 | 14 | 14 |
| 2019 May | 1 | 19 | 20 |
| 2019 April | 0 | 4 | 4 |
| 2019 March | 0 | 1 | 1 |
| 2019 February | 0 | 5 | 5 |
| 2018 November | 0 | 7 | 7 |
| 2018 October | 0 | 1 | 1 |
| 2018 July | 0 | 1 | 1 |
| 2018 June | 0 | 5 | 5 |
| 2018 May | 0 | 8 | 8 |
| 2018 April | 0 | 3 | 3 |
| 2018 March | 0 | 2 | 2 |
| 2018 February | 24 | 10 | 34 |
| 2018 January | 36 | 9 | 45 |
| 2017 December | 44 | 11 | 55 |
| 2017 November | 33 | 8 | 41 |
| 2017 October | 27 | 9 | 36 |
| 2017 September | 18 | 10 | 28 |
| 2017 August | 26 | 8 | 34 |
| 2017 July | 24 | 12 | 36 |
| 2017 June | 36 | 15 | 51 |
| 2017 May | 26 | 14 | 40 |
| 2017 April | 31 | 17 | 48 |
| 2017 March | 27 | 21 | 48 |
| 2017 February | 23 | 9 | 32 |
| 2017 January | 27 | 17 | 44 |
| 2016 December | 37 | 7 | 44 |
| 2016 November | 43 | 7 | 50 |
| 2016 October | 49 | 17 | 66 |
| 2016 September | 51 | 17 | 68 |
| 2016 August | 53 | 16 | 69 |
| 2016 July | 35 | 9 | 44 |
| 2016 June | 0 | 12 | 12 |
| 2016 May | 0 | 13 | 13 |
| 2016 April | 0 | 2 | 2 |
| 2016 March | 4 | 3 | 7 |
| 2016 February | 1 | 3 | 4 |
| 2016 January | 0 | 23 | 23 |
| 2015 December | 5 | 20 | 25 |
| 2015 November | 3 | 23 | 26 |
| 2015 October | 4 | 14 | 18 |
| 2015 September | 2 | 8 | 10 |
| 2015 August | 3 | 6 | 9 |
| 2015 July | 44 | 2 | 46 |
| 2015 June | 41 | 17 | 58 |
| 2015 May | 76 | 21 | 97 |
| 2015 April | 58 | 33 | 91 |
| 2015 March | 63 | 21 | 84 |
| 2015 February | 38 | 14 | 52 |
| 2015 January | 46 | 13 | 59 |
| 2014 December | 49 | 10 | 59 |
| 2014 November | 43 | 14 | 57 |
| 2014 October | 51 | 24 | 75 |
| 2014 September | 0 | 1 | 1 |
| 2014 February | 3 | 0 | 3 |
| 2014 January | 0 | 1 | 1 |
| 2013 November | 2 | 0 | 2 |
| 2013 October | 1 | 0 | 1 |
| 2013 September | 1 | 1 | 2 |
| 2013 May | 1 | 2 | 3 |
| 2013 April | 1 | 1 | 2 |
| 2013 February | 0 | 1 | 1 |
| 2013 January | 0 | 1 | 1 |
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