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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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 6 | 12 | 18 |
| 2024 Octubre | 47 | 40 | 87 |
| 2024 Septiembre | 37 | 20 | 57 |
| 2024 Agosto | 65 | 41 | 106 |
| 2024 Julio | 48 | 29 | 77 |
| 2024 Junio | 58 | 28 | 86 |
| 2024 Mayo | 41 | 24 | 65 |
| 2024 Abril | 27 | 14 | 41 |
| 2024 Marzo | 39 | 34 | 73 |
| 2024 Febrero | 33 | 24 | 57 |
| 2024 Enero | 34 | 17 | 51 |
| 2023 Diciembre | 32 | 14 | 46 |
| 2023 Noviembre | 53 | 19 | 72 |
| 2023 Octubre | 34 | 12 | 46 |
| 2023 Septiembre | 23 | 21 | 44 |
| 2023 Agosto | 28 | 11 | 39 |
| 2023 Julio | 26 | 24 | 50 |
| 2023 Junio | 25 | 22 | 47 |
| 2023 Mayo | 14 | 9 | 23 |
| 2023 Abril | 18 | 12 | 30 |
| 2023 Marzo | 24 | 20 | 44 |
| 2023 Febrero | 26 | 12 | 38 |
| 2023 Enero | 32 | 28 | 60 |
| 2022 Diciembre | 35 | 23 | 58 |
| 2022 Noviembre | 28 | 23 | 51 |
| 2022 Octubre | 36 | 23 | 59 |
| 2022 Septiembre | 23 | 33 | 56 |
| 2022 Agosto | 21 | 30 | 51 |
| 2022 Julio | 29 | 28 | 57 |
| 2022 Junio | 18 | 22 | 40 |
| 2022 Mayo | 20 | 30 | 50 |
| 2022 Abril | 23 | 39 | 62 |
| 2022 Marzo | 24 | 43 | 67 |
| 2022 Febrero | 24 | 18 | 42 |
| 2022 Enero | 30 | 32 | 62 |
| 2021 Diciembre | 20 | 35 | 55 |
| 2021 Noviembre | 25 | 37 | 62 |
| 2021 Octubre | 44 | 39 | 83 |
| 2021 Septiembre | 42 | 40 | 82 |
| 2021 Agosto | 38 | 31 | 69 |
| 2021 Julio | 59 | 35 | 94 |
| 2021 Junio | 39 | 34 | 73 |
| 2021 Mayo | 23 | 34 | 57 |
| 2021 Abril | 50 | 60 | 110 |
| 2021 Marzo | 50 | 28 | 78 |
| 2021 Febrero | 49 | 21 | 70 |
| 2021 Enero | 29 | 10 | 39 |
| 2020 Diciembre | 22 | 15 | 37 |
| 2020 Noviembre | 19 | 16 | 35 |
| 2020 Octubre | 18 | 8 | 26 |
| 2020 Septiembre | 10 | 5 | 15 |
| 2020 Agosto | 11 | 17 | 28 |
| 2020 Julio | 13 | 9 | 22 |
| 2020 Junio | 17 | 18 | 35 |
| 2020 Mayo | 25 | 29 | 54 |
| 2020 Abril | 13 | 16 | 29 |
| 2020 Marzo | 17 | 17 | 34 |
| 2020 Febrero | 3 | 2 | 5 |
| 2020 Enero | 0 | 7 | 7 |
| 2019 Diciembre | 0 | 7 | 7 |
| 2019 Noviembre | 0 | 4 | 4 |
| 2019 Octubre | 0 | 2 | 2 |
| 2019 Septiembre | 0 | 4 | 4 |
| 2019 Agosto | 0 | 7 | 7 |
| 2019 Julio | 0 | 13 | 13 |
| 2019 Junio | 0 | 14 | 14 |
| 2019 Mayo | 1 | 19 | 20 |
| 2019 Abril | 0 | 4 | 4 |
| 2019 Marzo | 0 | 1 | 1 |
| 2019 Febrero | 0 | 5 | 5 |
| 2018 Noviembre | 0 | 7 | 7 |
| 2018 Octubre | 0 | 1 | 1 |
| 2018 Julio | 0 | 1 | 1 |
| 2018 Junio | 0 | 5 | 5 |
| 2018 Mayo | 0 | 8 | 8 |
| 2018 Abril | 0 | 3 | 3 |
| 2018 Marzo | 0 | 2 | 2 |
| 2018 Febrero | 24 | 10 | 34 |
| 2018 Enero | 36 | 9 | 45 |
| 2017 Diciembre | 44 | 11 | 55 |
| 2017 Noviembre | 33 | 8 | 41 |
| 2017 Octubre | 27 | 9 | 36 |
| 2017 Septiembre | 18 | 10 | 28 |
| 2017 Agosto | 26 | 8 | 34 |
| 2017 Julio | 24 | 12 | 36 |
| 2017 Junio | 36 | 15 | 51 |
| 2017 Mayo | 26 | 14 | 40 |
| 2017 Abril | 31 | 17 | 48 |
| 2017 Marzo | 27 | 21 | 48 |
| 2017 Febrero | 23 | 9 | 32 |
| 2017 Enero | 27 | 17 | 44 |
| 2016 Diciembre | 37 | 7 | 44 |
| 2016 Noviembre | 43 | 7 | 50 |
| 2016 Octubre | 49 | 17 | 66 |
| 2016 Septiembre | 51 | 17 | 68 |
| 2016 Agosto | 53 | 16 | 69 |
| 2016 Julio | 35 | 9 | 44 |
| 2016 Junio | 0 | 12 | 12 |
| 2016 Mayo | 0 | 13 | 13 |
| 2016 Abril | 0 | 2 | 2 |
| 2016 Marzo | 4 | 3 | 7 |
| 2016 Febrero | 1 | 3 | 4 |
| 2016 Enero | 0 | 23 | 23 |
| 2015 Diciembre | 5 | 20 | 25 |
| 2015 Noviembre | 3 | 23 | 26 |
| 2015 Octubre | 4 | 14 | 18 |
| 2015 Septiembre | 2 | 8 | 10 |
| 2015 Agosto | 3 | 6 | 9 |
| 2015 Julio | 44 | 2 | 46 |
| 2015 Junio | 41 | 17 | 58 |
| 2015 Mayo | 76 | 21 | 97 |
| 2015 Abril | 58 | 33 | 91 |
| 2015 Marzo | 63 | 21 | 84 |
| 2015 Febrero | 38 | 14 | 52 |
| 2015 Enero | 46 | 13 | 59 |
| 2014 Diciembre | 49 | 10 | 59 |
| 2014 Noviembre | 43 | 14 | 57 |
| 2014 Octubre | 51 | 24 | 75 |
| 2014 Septiembre | 0 | 1 | 1 |
| 2014 Febrero | 3 | 0 | 3 |
| 2014 Enero | 0 | 1 | 1 |
| 2013 Noviembre | 2 | 0 | 2 |
| 2013 Octubre | 1 | 0 | 1 |
| 2013 Septiembre | 1 | 1 | 2 |
| 2013 Mayo | 1 | 2 | 3 |
| 2013 Abril | 1 | 1 | 2 |
| 2013 Febrero | 0 | 1 | 1 |
| 2013 Enero | 0 | 1 | 1 |
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