Ustekinumab: moving the target from psoriasis to Crohn's disease

Expert Rev Gastroenterol Hepatol. 2014 Jan;8(1):5-13. doi: 10.1586/17474124.2014.850414. Epub 2013 Nov 25.

Abstract

Crohn's disease (CD) is an inflammatory bowel disease whose precise etiology is still unknown, and therefore a causal therapy is not yet available. Studies showing the overexpression of IL-12 and IL-23, polymorphisms in genes encoding those cytokines and their receptors and genome-wide association studies have linked Crohn's pathogenesis with IL-12/23 pathway. Ustekinumab is a novel therapeutic IgG₁ kappa monoclonal antibody that modulates Th1 and Th17 function, by blocking the p40 subunit of both IL-12 and IL-23 and preventing the interaction with their receptors on T cells, natural killer cells and antigen-presenting cells with established efficacy in psoriasis. This review will mainly focus on the available evidence on the role of ustekinumab in moderate-to-severe CD. The potential role of this biologic in the armamentarium of CD therapy is discussed.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Crohn Disease / drug therapy*
  • Humans
  • Interleukin-12 / antagonists & inhibitors
  • Interleukin-23 / antagonists & inhibitors
  • Interleukin-23 / drug effects
  • Psoriasis / drug therapy*
  • Severity of Illness Index
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors
  • Ustekinumab

Substances

  • Antibodies, Monoclonal, Humanized
  • Interleukin-23
  • Tumor Necrosis Factor-alpha
  • Interleukin-12
  • Ustekinumab