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        "resumen" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Psoriasis is a chronic disease characterized by recurrent flares and in some patients the outbreaks occur so close together that continuous treatment is necessary&#46; Newly developed biologic agents such as ustekinumab are often used in such cases because they offer the possibility of long-term treatment without the risk of cumulative toxicity associated with many traditional psoriasis therapies&#46; There are&#44; however&#44; situations when biologic treatment might have to be interrupted&#46; In such cases&#44; it is important to discuss the issues with the patient and carefully weigh the benefits and risks of continuing or interrupting treatment&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">In this chapter&#44; we review a series of clinical cases and provide insights that will facilitate decision-making in routine clinical practice regarding the use of ustekinumab in special circumstances&#46; The cases discussed include patients who become or wish to become pregnant&#44; temporary interruptions due to vaccination or surgery&#44; and patients who plan to travel to or come from a country where opportunistic infections are endemic&#46;</p>"
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                    0 => array:2 [
                      "doi" => "10.1016/j.jaad.2009.05.004"
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                        "link" => array:1 [
                          0 => array:2 [
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                            2 => "K&#46;L&#46; Jones"
                            3 => "J&#46; L&#243;pez-Jim&#233;nez"
                            4 => "E&#46; Salas"
                            5 => "N&#46; Mirrasoul"
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                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.1111/j.1365-2133.2010.09899.x"
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                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "2010"
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                        "paginaFinal" => "339"
                        "link" => array:1 [
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                            "web" => "Medline"
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                      "titulo" => "Psoriasis and pregnancy outcomes&#58; A nationwide population-based study"
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                            0 => "Y&#46;W&#46; Yang"
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                            2 => "Y&#46;H&#46; Chen"
                            3 => "H&#46;C&#46; Lin"
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                        "paginaFinal" => "77"
                        "link" => array:1 [
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                      "titulo" => "Tumor necrosis factor-alpha inhibition and VATER association&#58; a causal relationship"
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                        "paginaFinal" => "1017"
                        "link" => array:1 [
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                      "titulo" => "A safety assessment of tumor necrosis factor antagonists during pregnancy&#58; a review of the Food and Drug Administration database"
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                          "etal" => false
                          "autores" => array:5 [
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                            2 => "L&#46;R&#46; Ricca"
                            3 => "J&#46; Valeriano"
                            4 => "F&#46;B&#46; Vasey"
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                      "doi" => "10.3899/jrheum.080545"
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                        "tituloSerie" => "J Rheumatol"
                        "fecha" => "2009"
                        "volumen" => "36"
                        "paginaInicial" => "635"
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                      "titulo" => "Development in the cynomolgus macaque following administration of ustekinumab&#44; a human anti-IL-12&#47;23p40 monoclonal antibody&#44; during pregnancy and lactation"
                      "autores" => array:1 [
                        0 => array:2 [
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                            0 => "P&#46;L&#46; Martin"
                            1 => "C&#46; Sachs"
                            2 => "N&#46; Imai"
                            3 => "H&#46; Tsusaki"
                            4 => "S&#46; Oneda"
                            5 => "Q&#46; Jiao"
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                    ]
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                      "doi" => "10.1002/bdrb.20250"
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                        "tituloSerie" => "Birth Defects Res B Dev Reprod Toxicol"
                        "fecha" => "2010"
                        "volumen" => "89"
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                        "paginaFinal" => "363"
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                  "referenciaCompleta" => "Data on file&#46; Reports of pregnancy with ustekinumab&#58; STE&#47;Inj&#47;DoF&#47;Sep2010&#47;EMEA001&#46; Janssen&#59; 2010&#46;"
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                  "referenciaCompleta" => "Ficha t&#233;cnica ustekinumab&#46; Disponible en&#58; http&#58;&#47;&#47;www&#46;emea&#46;europa&#46;eu&#46; Diciembre 2009&#46;"
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                    0 => array:2 [
                      "titulo" => "Guidelines of care for the management of psoriasis and psoriatic arthritis&#58; Section 1&#46; Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics"
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                        0 => array:2 [
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                            2 => "S&#46;R&#46; Feldman"
                            3 => "A&#46;S&#46; Van Voorhees"
                            4 => "C&#46;L&#46; Leonardi"
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                        "paginaFinal" => "850"
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                          ]
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                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "British Association of Dermatologists&#8217; guidelines for biologic interventions for psoriasis 2009"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "&#40;Chair of Guideline Group&#41;"
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46;H&#46; Smith"
                            1 => "A&#46;V&#46; Anstey"
                            2 => "J&#46;N&#46; Barker"
                            3 => "A&#46;D&#46; Burden"
                            4 => "R&#46;J&#46; Chalmers"
                            5 => "D&#46;A&#46; Chandler"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-2133.2009.09505.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "2009"
                        "volumen" => "161"
                        "paginaInicial" => "987"
                        "paginaFinal" => "1019"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19857207"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effects of ustekinumab administration on primate&#47;human antigen-recall and humoral immune response functions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Brodmerkel"
                            1 => "Y&#46; Zhu"
                            2 => "Q&#46; Jiao"
                            3 => "J&#46; Cornacoff"
                            4 => "G&#46; Treacy"
                            5 => "M&#46;A&#46; Mascelli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Drugs Dermatol"
                        "fecha" => "2010"
                        "volumen" => "9"
                        "paginaInicial" => "677"
                        "paginaFinal" => "683"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20645530"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Interrupci&#243;n temporal del tratamiento con etanercept"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46;P&#46; Ruiz-Genao"
                            1 => "J&#46;L&#46; L&#243;pez-Estebaranz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "2010"
                        "volumen" => "101"
                        "numero" => "Suppl 1"
                        "paginaInicial" => "102"
                        "paginaFinal" => "105"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20492889"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Gestion des principales situations particuli&#233;res au cours d&#8217;un traitement par anti-TNF-a"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "Annexe III"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Ann Dermatol Vennereol"
                        "fecha" => "2007"
                        "volumen" => "134"
                        "paginaInicial" => "1008"
                        "paginaFinal" => "1013"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The role of interleukin-12 in human infectious diseases&#58; only a faint signature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46; Fieschi"
                            1 => "J&#46;L&#46; Casanova"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/eji.200324038"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Immunol&#46;"
                        "fecha" => "2003"
                        "volumen" => "33"
                        "paginaInicial" => "1461"
                        "paginaFinal" => "1464"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12778462"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Severe mycobacterial and Salmonella infections in interleukin-12 receptor-deficient patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; De Jong"
                            1 => "F&#46; Altare"
                            2 => "I&#46;A&#46; Haagen"
                            3 => "D&#46;G&#46; Elferink"
                            4 => "T&#46; Boer"
                            5 => "P&#46;J&#46; Van Breda Vriesman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Science"
                        "fecha" => "1998"
                        "volumen" => "280"
                        "paginaInicial" => "1435"
                        "paginaFinal" => "1438"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9603733"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Paracoccidioides brasiliensis disseminated disease in a patient with inherited deficiency in the b1 subunit of the interleukin &#40;IL&#41;-12&#47;IL-23 receptor"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; De Moraes-Vasconcelos"
                            1 => "A&#46;S&#46; Grumach"
                            2 => "A&#46; Yamaguti"
                            3 => "M&#46;E&#46; Andrade"
                            4 => "C&#46; Fieschi"
                            5 => "L&#46; De Beaucoudrey"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1086/432119"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Infect Dis"
                        "fecha" => "2005"
                        "volumen" => "41"
                        "paginaInicial" => "e31"
                        "paginaFinal" => "e37"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16028144"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A case of interleukin-12 receptor b-1 deficiency with recurrent leishmaniasis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "O&#46; Sanal"
                            1 => "G&#46; Turkkani"
                            2 => "F&#46; Gumruk"
                            3 => "L&#46; Yel"
                            4 => "G&#46; Secmeer"
                            5 => "I&#46; Tezcan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.inf.0000258696.64507.0f"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Infect Dis J"
                        "fecha" => "2007"
                        "volumen" => "26"
                        "paginaInicial" => "366"
                        "paginaFinal" => "368"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17414409"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The use of ustekinumab in autoimmune disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46; Ryan"
                            1 => "B&#46; Thrash"
                            2 => "R&#46;B&#46; Warren"
                            3 => "A&#46; Menter"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1517/14712591003724670"
                      "Revista" => array:6 [
                        "tituloSerie" => "Expert Opin Biol Ther"
                        "fecha" => "2010"
                        "volumen" => "10"
                        "paginaInicial" => "587"
                        "paginaFinal" => "604"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20218921"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Disseminated Strongyloides stercoralis&#58; hyperinfection during medical immunosuppression"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Basile"
                            1 => "S&#46; Simzar"
                            2 => "J&#46; Bentow"
                            3 => "F&#46; Antelo"
                            4 => "P&#46; Shitabata"
                            5 => "S&#46;K&#46; Peng"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaad.2009.09.037"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2010"
                        "volumen" => "63"
                        "paginaInicial" => "896"
                        "paginaFinal" => "902"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20172622"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Strongyloides stercoralis hyperinfection in a patient with rheumatoid arthritis and bronchial asthma&#58; a case report"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "L&#46; Altintop"
                            1 => "B&#46; Cakar"
                            2 => "M&#46; Hokelek"
                            3 => "A&#46; Bektas"
                            4 => "L&#46; Yildiz"
                            5 => "M&#46; Karaoglanoglu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1476-0711-9-27"
                      "Revista" => array:5 [
                        "tituloSerie" => "Ann Clin Microbiol Antimicrob"
                        "fecha" => "2010"
                        "volumen" => "9"
                        "paginaInicial" => "27"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20849666"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Strongyloides stercoralis hyperinfection in a patient with rheumatoid arthritis after anti-TNF-alpha therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46; Krishnamurthy"
                            1 => "H&#46;E&#46; Dincer"
                            2 => "D&#46; Whittemore"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/RHU.0b013e3180690933"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Rheumatol"
                        "fecha" => "2007"
                        "volumen" => "13"
                        "paginaInicial" => "150"
                        "paginaFinal" => "152"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17551383"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Infecci&#243;n por Strongyloides stercoralis en pacientes trasplantados renales"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46; Beltr&#225;n Catal&#225;n"
                            1 => "J&#46;F&#46; Crespo Albiach"
                            2 => "A&#46;I&#46; Morales Garc&#237;a"
                            3 => "E&#46; Gavela Mart&#237;nez"
                            4 => "J&#46;L&#46; G&#243;rriz Teruel"
                            5 => "L&#46;M&#46; Pallard&#243; Mateu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3265/Nefrologia.2009.29.5.4525.en.full"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nefrolog&#237;a"
                        "fecha" => "2009"
                        "volumen" => "29"
                        "paginaInicial" => "482"
                        "paginaFinal" => "485"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19820762"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
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Journal Information
Vol. 103. Issue S2.
Actualización del uso de ustekinumab: un ava nce en el tratamiento de la psoriasis
Pages 45-51 (October 2012)
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Vol. 103. Issue S2.
Actualización del uso de ustekinumab: un ava nce en el tratamiento de la psoriasis
Pages 45-51 (October 2012)
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Ustekinumab en situaciones especiales: embarazo, interrupciones temporales (vacunaciones, cirugía) y otros
Ustekinumab in special situations: pregnancy, temporal interruptions (vaccinations, surgery) and others
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R. Rivera
Corresponding author
rriveradiaz@hotmail.com

Autor para correspondencia.
, F. Vanaclocha
Servicio de Dermatología. Hospital Universitario 12 de Octubre. Madrid. España
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Article information
Resumen

La psoriasis es una enfermedad crónica que cursa en brotes. Algunos pacientes los sufren con tanta frecuencia que precisan un tratamiento continuo para su control. Es en muchos de estos pacientes donde empleamos las nuevas terapias biológicas como el ustekinumab, que nos permiten tratamientos prolongados evitando la toxicidad acumulada que tienen muchos de los tratamientos clásicos. Sin embargo, a lo largo del curso de estos tratamientos hay situaciones en las que sería deseable interrumpirlos o al menos sopesar adecuadamente con el paciente el riesgo-beneficio de mantenerlos.

En este capítulo, partiendo de un caso clínico, revisamos algunas de estas situaciones especiales como el embarazo, las interrupciones temporales por vacunaciones o cirugía y qué tenemos que hacer en caso de que nuestros pacientes en tratamiento con ustekinumab viajen al extranjero o procedan de zonas endémicas de determinados problemas infecciosos. Pretendemos facilitar la toma de decisiones ante estas situaciones especiales que se nos plantean a diario en la consulta.

Palabras clave:
Ustekinumab
Embarazo
Vacunas
Cirugía
Infecciones oportunistas
Abstract

Psoriasis is a chronic disease characterized by recurrent flares and in some patients the outbreaks occur so close together that continuous treatment is necessary. Newly developed biologic agents such as ustekinumab are often used in such cases because they offer the possibility of long-term treatment without the risk of cumulative toxicity associated with many traditional psoriasis therapies. There are, however, situations when biologic treatment might have to be interrupted. In such cases, it is important to discuss the issues with the patient and carefully weigh the benefits and risks of continuing or interrupting treatment.

In this chapter, we review a series of clinical cases and provide insights that will facilitate decision-making in routine clinical practice regarding the use of ustekinumab in special circumstances. The cases discussed include patients who become or wish to become pregnant, temporary interruptions due to vaccination or surgery, and patients who plan to travel to or come from a country where opportunistic infections are endemic.

Keywords:
Ustekinumab
Pregnancy
Vaccines
Surgery
Opportunistic infections
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Bibliografía
[1.]
C.S. Buhimschi, C.P. Weiner.
Medications in pregnancy and lactation: part 1.
Teratology. Obstet Gynecol, 113 (2009), pp. 166-188
[2.]
E.J. Horn, C.D. Chambers, A. Menter, A. Kimball.
International Psoriasis Council. Pregnancy outcomes in psoriasis: why do we know so little?.
J Am Acad Dermatol, 61 (2009), pp. e5-e8
[3.]
G. Bandoli, D.L. Johnson, K.L. Jones, J. López-Jiménez, E. Salas, N. Mirrasoul, et al.
Potentially modifiable risk factors for adverse pregnancy outcomes in women with psoriasis.
Br J Dermatol, 163 (2010), pp. 334-339
[4.]
Y.W. Yang, C.S. Chen, Y.H. Chen, H.C. Lin.
Psoriasis and pregnancy outcomes: A nationwide population-based study.
J Am Acad Dermatol, 64 (2011), pp. 71-77
[5.]
E. Vinet, C. Pineau, C. Gordon, A.E. Clarke, S. Bernatsky.
Anti-TNF therapy and pregnancy outcomes in women with inflammatory arthritis.
Expert Rev Clin Immunol, 5 (2009), pp. 27-34
[6.]
J.D. Carter, J. Valeriano, F.B. Vasey.
Tumor necrosis factor-alpha inhibition and VATER association: a causal relationship.
J Rheumatol, 33 (2006), pp. 1014-1017
[7.]
J.D. Carter, A. Ladhani, L.R. Ricca, J. Valeriano, F.B. Vasey.
A safety assessment of tumor necrosis factor antagonists during pregnancy: a review of the Food and Drug Administration database.
J Rheumatol, 36 (2009), pp. 635-641
[8.]
P.L. Martin, C. Sachs, N. Imai, H. Tsusaki, S. Oneda, Q. Jiao, et al.
Development in the cynomolgus macaque following administration of ustekinumab, a human anti-IL-12/23p40 monoclonal antibody, during pregnancy and lactation.
Birth Defects Res B Dev Reprod Toxicol, 89 (2010), pp. 351-363
[9.]
Data on file. Reports of pregnancy with ustekinumab: STE/Inj/DoF/Sep2010/EMEA001. Janssen; 2010.
[10.]
Ficha técnica ustekinumab. Disponible en: http://www.emea.europa.eu. Diciembre 2009.
[11.]
A. Menter, A. Gottlieb, S.R. Feldman, A.S. Van Voorhees, C.L. Leonardi, K.B. Gordon, et al.
Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 1. Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics.
J Am Acad Dermatol, 58 (2008), pp. 826-850
[12.]
C.H. Smith, A.V. Anstey, J.N. Barker, A.D. Burden, R.J. Chalmers, D.A. Chandler, (Chair of Guideline Group), et al.
British Association of Dermatologists’ guidelines for biologic interventions for psoriasis 2009.
Br J Dermatol, 161 (2009), pp. 987-1019
[13.]
C. Brodmerkel, Y. Zhu, Q. Jiao, J. Cornacoff, G. Treacy, M.A. Mascelli, et al.
Effects of ustekinumab administration on primate/human antigen-recall and humoral immune response functions.
J Drugs Dermatol, 9 (2010), pp. 677-683
[14.]
D.P. Ruiz-Genao, J.L. López-Estebaranz.
Interrupción temporal del tratamiento con etanercept.
Actas Dermosifiliogr, 101 (2010), pp. 102-105
[15.]
Annexe III.
Gestion des principales situations particuliéres au cours d’un traitement par anti-TNF-a.
Ann Dermatol Vennereol, 134 (2007), pp. 1008-1013
[16.]
C. Fieschi, J.L. Casanova.
The role of interleukin-12 in human infectious diseases: only a faint signature.
Eur J Immunol., 33 (2003), pp. 1461-1464
[17.]
R. De Jong, F. Altare, I.A. Haagen, D.G. Elferink, T. Boer, P.J. Van Breda Vriesman, et al.
Severe mycobacterial and Salmonella infections in interleukin-12 receptor-deficient patients.
Science, 280 (1998), pp. 1435-1438
[18.]
D. De Moraes-Vasconcelos, A.S. Grumach, A. Yamaguti, M.E. Andrade, C. Fieschi, L. De Beaucoudrey, et al.
Paracoccidioides brasiliensis disseminated disease in a patient with inherited deficiency in the b1 subunit of the interleukin (IL)-12/IL-23 receptor.
Clin Infect Dis, 41 (2005), pp. e31-e37
[19.]
O. Sanal, G. Turkkani, F. Gumruk, L. Yel, G. Secmeer, I. Tezcan, et al.
A case of interleukin-12 receptor b-1 deficiency with recurrent leishmaniasis.
Pediatr Infect Dis J, 26 (2007), pp. 366-368
[20.]
C. Ryan, B. Thrash, R.B. Warren, A. Menter.
The use of ustekinumab in autoimmune disease.
Expert Opin Biol Ther, 10 (2010), pp. 587-604
[21.]
A. Basile, S. Simzar, J. Bentow, F. Antelo, P. Shitabata, S.K. Peng, et al.
Disseminated Strongyloides stercoralis: hyperinfection during medical immunosuppression.
J Am Acad Dermatol, 63 (2010), pp. 896-902
[22.]
L. Altintop, B. Cakar, M. Hokelek, A. Bektas, L. Yildiz, M. Karaoglanoglu.
Strongyloides stercoralis hyperinfection in a patient with rheumatoid arthritis and bronchial asthma: a case report.
Ann Clin Microbiol Antimicrob, 9 (2010), pp. 27
[23.]
R. Krishnamurthy, H.E. Dincer, D. Whittemore.
Strongyloides stercoralis hyperinfection in a patient with rheumatoid arthritis after anti-TNF-alpha therapy.
J Clin Rheumatol, 13 (2007), pp. 150-152
[24.]
S. Beltrán Catalán, J.F. Crespo Albiach, A.I. Morales García, E. Gavela Martínez, J.L. Górriz Teruel, L.M. Pallardó Mateu.
Infección por Strongyloides stercoralis en pacientes trasplantados renales.
Copyright © 2012. Academia Española de Dermatología y Venereología
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