Ustekinumab en situaciones especiales: embarazo, interrupciones temporales (vacunaciones, cirugía) y otros
Ustekinumab in special situations: pregnancy, temporal interruptions (vaccinations, surgery) and others
R. Rivera
, F. Vanaclocha
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Servicio de Dermatología. Hospital Universitario 12 de Octubre. Madrid. España
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"apellidos" => "Bordas" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731012700091?idApp=UINPBA000044" "url" => "/00017310/00000103000000S2/v1_201304241722/S0001731012700091/v1_201304241722/es/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0001731012700078" "issn" => "00017310" "doi" => "10.1016/S0001-7310(12)70007-8" "estado" => "S300" "fechaPublicacion" => "2012-10-01" "aid" => "70007" "copyright" => "Academia Española de Dermatología y Venereología" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Actas Dermosifiliogr. 2012;103 Supl 2:39-44" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 962 "formatos" => array:3 [ "EPUB" => 1 "HTML" => 536 "PDF" => 425 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Ustekinumab. Neoplasias y otros aspectos de seguridad" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "39" "paginaFinal" => "44" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Ustekinumab. Neoplasms and Other Safety Aspects" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J. Santos-Juanes, P. Coto, C. Galache" "autores" => array:3 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "Santos-Juanes" ] 1 => array:2 [ "nombre" => "P." "apellidos" => "Coto" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Galache" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731012700078?idApp=UINPBA000044" "url" => "/00017310/00000103000000S2/v1_201304241722/S0001731012700078/v1_201304241722/es/main.assets" ] "es" => array:12 [ "idiomaDefecto" => true "titulo" => "Ustekinumab en situaciones especiales: embarazo, interrupciones temporales (vacunaciones, cirugía) y otros" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "45" "paginaFinal" => "51" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "R. Rivera, F. Vanaclocha" "autores" => array:2 [ 0 => array:4 [ "nombre" => "R." "apellidos" => "Rivera" "email" => array:1 [ 0 => "rriveradiaz@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "F." "apellidos" => "Vanaclocha" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Dermatología. Hospital Universitario 12 de Octubre. Madrid. España" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Autor para correspondencia." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Ustekinumab in special situations: pregnancy, temporal interruptions (vaccinations, surgery) and others" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec85098" "palabras" => array:5 [ 0 => "Ustekinumab" 1 => "Embarazo" 2 => "Vacunas" 3 => "Cirugía" 4 => "Infecciones oportunistas" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec85097" "palabras" => array:5 [ 0 => "Ustekinumab" 1 => "Pregnancy" 2 => "Vaccines" 3 => "Surgery" 4 => "Opportunistic infections" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">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.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">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.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "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. 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.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">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.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:24 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 4 | 9 | 13 |
| 2024 Octubre | 38 | 35 | 73 |
| 2024 Septiembre | 27 | 22 | 49 |
| 2024 Agosto | 45 | 62 | 107 |
| 2024 Julio | 40 | 30 | 70 |
| 2024 Junio | 57 | 38 | 95 |
| 2024 Mayo | 33 | 36 | 69 |
| 2024 Abril | 34 | 35 | 69 |
| 2024 Marzo | 29 | 37 | 66 |
| 2024 Febrero | 27 | 35 | 62 |
| 2024 Enero | 22 | 24 | 46 |
| 2023 Diciembre | 39 | 27 | 66 |
| 2023 Noviembre | 33 | 23 | 56 |
| 2023 Octubre | 33 | 18 | 51 |
| 2023 Septiembre | 39 | 31 | 70 |
| 2023 Agosto | 27 | 23 | 50 |
| 2023 Julio | 32 | 28 | 60 |
| 2023 Junio | 39 | 24 | 63 |
| 2023 Mayo | 20 | 16 | 36 |
| 2023 Abril | 29 | 20 | 49 |
| 2023 Marzo | 71 | 23 | 94 |
| 2023 Febrero | 30 | 19 | 49 |
| 2023 Enero | 38 | 26 | 64 |
| 2022 Diciembre | 29 | 37 | 66 |
| 2022 Noviembre | 34 | 44 | 78 |
| 2022 Octubre | 36 | 28 | 64 |
| 2022 Septiembre | 27 | 35 | 62 |
| 2022 Agosto | 32 | 38 | 70 |
| 2022 Julio | 36 | 45 | 81 |
| 2022 Junio | 24 | 33 | 57 |
| 2022 Mayo | 30 | 36 | 66 |
| 2022 Abril | 40 | 44 | 84 |
| 2022 Marzo | 27 | 58 | 85 |
| 2022 Febrero | 26 | 31 | 57 |
| 2022 Enero | 40 | 43 | 83 |
| 2021 Diciembre | 21 | 40 | 61 |
| 2021 Noviembre | 32 | 42 | 74 |
| 2021 Octubre | 35 | 49 | 84 |
| 2021 Septiembre | 21 | 49 | 70 |
| 2021 Agosto | 32 | 49 | 81 |
| 2021 Julio | 38 | 40 | 78 |
| 2021 Junio | 33 | 38 | 71 |
| 2021 Mayo | 49 | 43 | 92 |
| 2021 Abril | 63 | 48 | 111 |
| 2021 Marzo | 43 | 42 | 85 |
| 2021 Febrero | 27 | 23 | 50 |
| 2021 Enero | 32 | 22 | 54 |
| 2020 Diciembre | 16 | 25 | 41 |
| 2020 Noviembre | 15 | 24 | 39 |
| 2020 Octubre | 30 | 17 | 47 |
| 2020 Septiembre | 7 | 25 | 32 |
| 2020 Agosto | 24 | 19 | 43 |
| 2020 Julio | 18 | 17 | 35 |
| 2020 Junio | 22 | 32 | 54 |
| 2020 Mayo | 29 | 34 | 63 |
| 2020 Abril | 17 | 22 | 39 |
| 2020 Marzo | 20 | 24 | 44 |
| 2020 Febrero | 31 | 5 | 36 |
| 2020 Enero | 0 | 8 | 8 |
| 2019 Diciembre | 0 | 6 | 6 |
| 2019 Noviembre | 1 | 8 | 9 |
| 2019 Octubre | 0 | 7 | 7 |
| 2019 Septiembre | 0 | 4 | 4 |
| 2019 Agosto | 0 | 9 | 9 |
| 2019 Julio | 0 | 14 | 14 |
| 2019 Junio | 0 | 20 | 20 |
| 2019 Mayo | 0 | 59 | 59 |
| 2019 Abril | 1 | 28 | 29 |
| 2019 Marzo | 0 | 3 | 3 |
| 2019 Febrero | 0 | 4 | 4 |
| 2019 Enero | 0 | 1 | 1 |
| 2018 Diciembre | 0 | 4 | 4 |
| 2018 Noviembre | 0 | 1 | 1 |
| 2018 Octubre | 0 | 2 | 2 |
| 2018 Septiembre | 0 | 5 | 5 |
| 2018 Agosto | 0 | 27 | 27 |
| 2018 Julio | 0 | 4 | 4 |
| 2018 Junio | 0 | 5 | 5 |
| 2018 Mayo | 0 | 8 | 8 |
| 2018 Abril | 0 | 6 | 6 |
| 2018 Marzo | 0 | 5 | 5 |
| 2018 Febrero | 23 | 11 | 34 |
| 2018 Enero | 20 | 11 | 31 |
| 2017 Diciembre | 31 | 17 | 48 |
| 2017 Noviembre | 26 | 13 | 39 |
| 2017 Octubre | 17 | 34 | 51 |
| 2017 Septiembre | 18 | 25 | 43 |
| 2017 Agosto | 19 | 18 | 37 |
| 2017 Julio | 15 | 15 | 30 |
| 2017 Junio | 23 | 22 | 45 |
| 2017 Mayo | 24 | 19 | 43 |
| 2017 Abril | 28 | 22 | 50 |
| 2017 Marzo | 23 | 12 | 35 |
| 2017 Febrero | 29 | 31 | 60 |
| 2017 Enero | 30 | 17 | 47 |
| 2016 Diciembre | 30 | 15 | 45 |
| 2016 Noviembre | 34 | 16 | 50 |
| 2016 Octubre | 39 | 11 | 50 |
| 2016 Septiembre | 35 | 32 | 67 |
| 2016 Agosto | 31 | 12 | 43 |
| 2016 Julio | 21 | 5 | 26 |
| 2016 Junio | 0 | 6 | 6 |
| 2016 Mayo | 0 | 14 | 14 |
| 2016 Abril | 0 | 1 | 1 |
| 2016 Marzo | 0 | 3 | 3 |
| 2016 Febrero | 0 | 4 | 4 |
| 2016 Enero | 0 | 11 | 11 |
| 2015 Diciembre | 1 | 6 | 7 |
| 2015 Noviembre | 6 | 10 | 16 |
| 2015 Octubre | 4 | 10 | 14 |
| 2015 Septiembre | 9 | 10 | 19 |
| 2015 Agosto | 8 | 9 | 17 |
| 2015 Julio | 42 | 2 | 44 |
| 2015 Junio | 51 | 8 | 59 |
| 2015 Mayo | 61 | 22 | 83 |
| 2015 Abril | 48 | 19 | 67 |
| 2015 Marzo | 44 | 11 | 55 |
| 2015 Febrero | 25 | 10 | 35 |
| 2015 Enero | 20 | 14 | 34 |
| 2014 Diciembre | 38 | 8 | 46 |
| 2014 Noviembre | 30 | 14 | 44 |
| 2014 Octubre | 33 | 23 | 56 |
| 2014 Septiembre | 1 | 1 | 2 |
| 2014 Junio | 1 | 0 | 1 |
| 2014 Mayo | 1 | 0 | 1 |
| 2014 Marzo | 1 | 0 | 1 |
| 2014 Enero | 0 | 1 | 1 |
| 2013 Septiembre | 1 | 2 | 3 |
| 2013 Julio | 1 | 1 | 2 |
| 2013 Junio | 1 | 6 | 7 |
| 2013 Abril | 1 | 1 | 2 |
| 2013 Febrero | 3 | 4 | 7 |
| 2013 Enero | 0 | 2 | 2 |
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