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Hypersensitivity Reaction to Ustekinumab in Pediatric and Young Adult Inflammatory Bowel Disease Patients: A Case Series

Ustekinumab (UST) is a human IgG1K monoclonal antibody that binds to the p40 receptor subunit bound by cytokines IL-12 and IL-23. It is indicated in both Crohn’s disease and ulcerative colitis as a second-line agent. The safety and efficacy of UST in children and young adults has not been thoroughly...

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Autores principales: Sunny, Julee, Fonseca, Ashley G., Crim, Alisa Muñiz, Goyal, Alka, Felipez, Lina M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins, Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10158453/
https://www.ncbi.nlm.nih.gov/pubmed/37168900
http://dx.doi.org/10.1097/PG9.0000000000000205
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author Sunny, Julee
Fonseca, Ashley G.
Crim, Alisa Muñiz
Goyal, Alka
Felipez, Lina M.
author_facet Sunny, Julee
Fonseca, Ashley G.
Crim, Alisa Muñiz
Goyal, Alka
Felipez, Lina M.
author_sort Sunny, Julee
collection PubMed
description Ustekinumab (UST) is a human IgG1K monoclonal antibody that binds to the p40 receptor subunit bound by cytokines IL-12 and IL-23. It is indicated in both Crohn’s disease and ulcerative colitis as a second-line agent. The safety and efficacy of UST in children and young adults has not been thoroughly studied. We report a case series of six pediatric patients and young adults who developed hypersensitivity reactions during intravenous infusion with UST. These reactions ranged from mild allergic reactions to anaphylaxis, with no detectable antibodies if tested. We hypothesize the reaction could be secondary to ethylenediaminetetraacetic acid, which is present solely in the intravenous preparation. Patients who experience hypersensitivity reactions during their UST infusion may safely receive subcutaneous preparations of UST, as demonstrated by some patients who received it based on physician discretion. Further investigation is required to establish the etiology of infusion reactions.
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spelling pubmed-101584532023-05-09 Hypersensitivity Reaction to Ustekinumab in Pediatric and Young Adult Inflammatory Bowel Disease Patients: A Case Series Sunny, Julee Fonseca, Ashley G. Crim, Alisa Muñiz Goyal, Alka Felipez, Lina M. JPGN Rep Brief Report Ustekinumab (UST) is a human IgG1K monoclonal antibody that binds to the p40 receptor subunit bound by cytokines IL-12 and IL-23. It is indicated in both Crohn’s disease and ulcerative colitis as a second-line agent. The safety and efficacy of UST in children and young adults has not been thoroughly studied. We report a case series of six pediatric patients and young adults who developed hypersensitivity reactions during intravenous infusion with UST. These reactions ranged from mild allergic reactions to anaphylaxis, with no detectable antibodies if tested. We hypothesize the reaction could be secondary to ethylenediaminetetraacetic acid, which is present solely in the intravenous preparation. Patients who experience hypersensitivity reactions during their UST infusion may safely receive subcutaneous preparations of UST, as demonstrated by some patients who received it based on physician discretion. Further investigation is required to establish the etiology of infusion reactions. Lippincott Williams & Wilkins, Inc. 2022-04-27 /pmc/articles/PMC10158453/ /pubmed/37168900 http://dx.doi.org/10.1097/PG9.0000000000000205 Text en Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Brief Report
Sunny, Julee
Fonseca, Ashley G.
Crim, Alisa Muñiz
Goyal, Alka
Felipez, Lina M.
Hypersensitivity Reaction to Ustekinumab in Pediatric and Young Adult Inflammatory Bowel Disease Patients: A Case Series
title Hypersensitivity Reaction to Ustekinumab in Pediatric and Young Adult Inflammatory Bowel Disease Patients: A Case Series
title_full Hypersensitivity Reaction to Ustekinumab in Pediatric and Young Adult Inflammatory Bowel Disease Patients: A Case Series
title_fullStr Hypersensitivity Reaction to Ustekinumab in Pediatric and Young Adult Inflammatory Bowel Disease Patients: A Case Series
title_full_unstemmed Hypersensitivity Reaction to Ustekinumab in Pediatric and Young Adult Inflammatory Bowel Disease Patients: A Case Series
title_short Hypersensitivity Reaction to Ustekinumab in Pediatric and Young Adult Inflammatory Bowel Disease Patients: A Case Series
title_sort hypersensitivity reaction to ustekinumab in pediatric and young adult inflammatory bowel disease patients: a case series
topic Brief Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10158453/
https://www.ncbi.nlm.nih.gov/pubmed/37168900
http://dx.doi.org/10.1097/PG9.0000000000000205
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