Cargando…

Dual Biologic Therapy in a Patient With Niemann-Pick Type C and Crohn Disease: A Case Report and Literature Review

Dual biologic therapy has become a new area of interest in inflammatory bowel disease (IBD). Monogenic/polygenic IBD and the role of genetics in IBD is an evolving field, with many of these patients having difficult treatment courses. We present a case of a teenage patient with Niemann-Pick disease...

Descripción completa

Detalles Bibliográficos
Autores principales: Hudson, Alexandra S., Almeida, Patricia, Huynh, Hien Q.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins, Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10158355/
https://www.ncbi.nlm.nih.gov/pubmed/37168644
http://dx.doi.org/10.1097/PG9.0000000000000225
_version_ 1785036911565340672
author Hudson, Alexandra S.
Almeida, Patricia
Huynh, Hien Q.
author_facet Hudson, Alexandra S.
Almeida, Patricia
Huynh, Hien Q.
author_sort Hudson, Alexandra S.
collection PubMed
description Dual biologic therapy has become a new area of interest in inflammatory bowel disease (IBD). Monogenic/polygenic IBD and the role of genetics in IBD is an evolving field, with many of these patients having difficult treatment courses. We present a case of a teenage patient with Niemann-Pick disease type C and Crohn colitis, who sustained clinical remission only after escalating to dual biologic therapy (anti-tumor necrosis factor alpha [infliximab] and anti-interleukin-12/anti-interleukin-23 [ustekinumab]). A literature review of dual biologic therapy in pediatric IBD revealed 8 case series and 1 cohort study. In pediatric patients with genetic disorders and IBD who are not responding adequately to biologic therapy, adding a second biologic medication with a different mechanism of action may be efficacious. Targeting both anti-tumor necrosis factor alpha (which induces pro-inflammatory cytokines) and the pro-inflammatory cytokines themselves (interleukin-12/interleukin-23) may be important in impaired macrophage function and increased cytokine response. Our case adds to the sparse literature on the utility of combining ustekinumab and infliximab in pediatric IBD and is the first to describe its use for treating ongoing active luminal disease.
format Online
Article
Text
id pubmed-10158355
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Lippincott Williams & Wilkins, Inc.
record_format MEDLINE/PubMed
spelling pubmed-101583552023-05-09 Dual Biologic Therapy in a Patient With Niemann-Pick Type C and Crohn Disease: A Case Report and Literature Review Hudson, Alexandra S. Almeida, Patricia Huynh, Hien Q. JPGN Rep Case Report Dual biologic therapy has become a new area of interest in inflammatory bowel disease (IBD). Monogenic/polygenic IBD and the role of genetics in IBD is an evolving field, with many of these patients having difficult treatment courses. We present a case of a teenage patient with Niemann-Pick disease type C and Crohn colitis, who sustained clinical remission only after escalating to dual biologic therapy (anti-tumor necrosis factor alpha [infliximab] and anti-interleukin-12/anti-interleukin-23 [ustekinumab]). A literature review of dual biologic therapy in pediatric IBD revealed 8 case series and 1 cohort study. In pediatric patients with genetic disorders and IBD who are not responding adequately to biologic therapy, adding a second biologic medication with a different mechanism of action may be efficacious. Targeting both anti-tumor necrosis factor alpha (which induces pro-inflammatory cytokines) and the pro-inflammatory cytokines themselves (interleukin-12/interleukin-23) may be important in impaired macrophage function and increased cytokine response. Our case adds to the sparse literature on the utility of combining ustekinumab and infliximab in pediatric IBD and is the first to describe its use for treating ongoing active luminal disease. Lippincott Williams & Wilkins, Inc. 2022-07-25 /pmc/articles/PMC10158355/ /pubmed/37168644 http://dx.doi.org/10.1097/PG9.0000000000000225 Text en Copyright © 2022 The Author(s). Published by Wolters Kluwer on behalf of European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Hudson, Alexandra S.
Almeida, Patricia
Huynh, Hien Q.
Dual Biologic Therapy in a Patient With Niemann-Pick Type C and Crohn Disease: A Case Report and Literature Review
title Dual Biologic Therapy in a Patient With Niemann-Pick Type C and Crohn Disease: A Case Report and Literature Review
title_full Dual Biologic Therapy in a Patient With Niemann-Pick Type C and Crohn Disease: A Case Report and Literature Review
title_fullStr Dual Biologic Therapy in a Patient With Niemann-Pick Type C and Crohn Disease: A Case Report and Literature Review
title_full_unstemmed Dual Biologic Therapy in a Patient With Niemann-Pick Type C and Crohn Disease: A Case Report and Literature Review
title_short Dual Biologic Therapy in a Patient With Niemann-Pick Type C and Crohn Disease: A Case Report and Literature Review
title_sort dual biologic therapy in a patient with niemann-pick type c and crohn disease: a case report and literature review
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10158355/
https://www.ncbi.nlm.nih.gov/pubmed/37168644
http://dx.doi.org/10.1097/PG9.0000000000000225
work_keys_str_mv AT hudsonalexandras dualbiologictherapyinapatientwithniemannpicktypecandcrohndiseaseacasereportandliteraturereview
AT almeidapatricia dualbiologictherapyinapatientwithniemannpicktypecandcrohndiseaseacasereportandliteraturereview
AT huynhhienq dualbiologictherapyinapatientwithniemannpicktypecandcrohndiseaseacasereportandliteraturereview