Digestive Endoscopy Unit, Department of Medicine, "Villa Sofia-Cervello" Hospital, Palermo, 90100, Italy.
Gastroenterology & Endoscopy Unit, S. Elia-Raimondi Hospital, Caltanissetta, 93100, Italy.
Immunotherapy. 2023 Dec;15(18):1539-1552. doi: 10.2217/imt-2023-0106. Epub 2023 Nov 29.
The therapeutic armamentarium for gastroenterologists in treating ulcerative colitis (UC) has been rapidly growing since the introduction of monoclonal antibodies directed against anti-TNFs. Ustekinumab is a monoclonal antibody binding the shared p40 subunit of IL-12 and IL-23, and the inhibition of these two cytokines, implicated in host response to microbial pathogens, has demonstrated clinical efficacy in different immune-mediated diseases, including moderate-to-severe UC. This narrative review summarizes the newest clinical evidence regarding the efficacy, effectiveness and safety of ustekinumab in moderate-to-severe UC, including specific situations (pregnancy, breastfeeding, elderly/pediatric populations, extraintestinal manifestations, acute severe UC, pouchitis and dual biological therapy). Finally, positioning is discussed in light of the existing evidence.
自抗 TNF 单克隆抗体问世以来，胃肠病学家治疗溃疡性结肠炎（UC）的治疗手段迅速发展。乌司奴单抗是一种单克隆抗体，可与 IL-12 和 IL-23 的共同 p40 亚单位结合，这两种细胞因子在宿主对微生物病原体的反应中起作用，在包括中重度 UC 在内的不同免疫介导性疾病中显示出临床疗效。本综述总结了乌司奴单抗治疗中重度 UC 的最新临床证据，包括特殊情况（妊娠、哺乳、老年/儿科人群、肠外表现、急性重度 UC、 pouchitis 和双重生物治疗）。最后，根据现有证据讨论了定位问题。
