Case Report
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Case Report: Successful Drug Desensitization to Ustekinumab in an Adult Patient with Crohn’s Disease

Year 2025, Volume: 7 Issue: 3, 471 - 475, 13.10.2025
https://doi.org/10.52827/hititmedj.1675463

Abstract

Objective: Ustekinumab is a biological agent used in the treatment of inflammatory diseases. Since biological therapies are targeted therapies, their use is increasing and the incidence of related reactions is increasing accordingly. We present this case because of the successful desensitization we applied to a patient who developed a reaction to ustekinumab.
Materials and methods: An adult Crohn's disease patient who experienced an adverse reaction to the fifth subcutaneous dose of ustekinumab was evaluated in our Immunology and Allergy clinic.
Results: The patient was successfully treated using the stepwise rapid drug desensitization protocol.
Conclusion: We present this case to emphasize the importance and awareness of desensitization in managing drug reactions in clinics such as Dermatology, Rheumatology and Gastroenterology where the drug is widely used.

Supporting Institution

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References

  • Ryan C, Thrash B, Warren RB, et al. The use of ustekinumab in autoimmune disease. Expert Opin Biol Ther 2010;10:587–604.
  • Johnson & Johnson. Content Lab. U.S. FDA Approves STELARA® [Ustekinumab] for Treatment of Adults with Moderately to Severely Active Crohn’s Disease. https://www. jnj.com/media-center/press-releases/fda-approves-stelaraustekinumab-for-treatment-of-adults-with-moderately-toseverely-active-crohns-disease (Accessed: September 4, 2021.)
  • European Medicines Agency. Stelara®.2018. https://www. ema.europa.eu/en/medicines/human/EPAR/stelara (Accessed: September 4, 2021.)
  • Yang BC, Castells MC. The who, what, where, when, why, and how of drug desensitization. Immunol Allergy Clin North Am 2022;42(2):403-420.
  • Murphy CA, Langrish CL, Chen Y, et al. Divergent pro- and anti-inflammatory roles for IL-23 and IL-12 in joint autoimmune inflammation. J Exp Med 2003;198(12):1951-1957.
  • Bavbek S, Pagani M, Alvarez-Cuesta E, et al. Hypersensitivity reactions to biologicals: an EAACI position paper. Allergy 2022;77(1):39-54.
  • Picard M, Galvao VR. Current knowledge and management of hypersensitivity reactions to monoclonal antibodies. J Allergy Clin Immunol Pract 2017;5:600-609.
  • Spencer EA, Kinnucan J, Wang J, et al. Real-World Experience with Acute Infusion Reactions to Ustekinumab at 2 Large Tertiary Care Centers. Crohns Colitis 360 2020 Apr 10;2(2):otaa022.
  • Naranjo CA, Busto U, Sellers EM, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther 1981;30(2):239-245.
  • Cohen B, Tomer G, Gavrilova T. Successful drug desensitization to ustekinumab in a patient with Crohn’s disease. Case Rep Gastroenterol 2021;15(2):657–661.
  • Torres J, Mehandru S, Colombel JF, et al. Crohn’s disease. Lancet 2017;389:1741–1755.
  • Feagan BG, Sandborn WJ, Gasink C, et al. Ustekinumab as Induction and Maintenance Therapy for Crohn’s Disease. N Engl J Med 2016;375(20):1946-1960.
  • Thomas PWA. Immediate infusion reaction to intravenous ustekinumab in three Crohn’s disease patients: a case report andreview of the literature. J Crohns Colitis 2021;15(1):162–164.
  • Cleveland NK, Masching A, Rubin DT. Hypersensitivity to IV ustekinumab but tolerance to subcutaneous ustekinumab in a patient with Crohn’s disease. Am J Gastroenterol 2018;113:1167–1168.
  • Yang BC, Castells MC. Rituximab hypersensitivity and desensitization: a personalized approach to treat cancer and connective tissue diseases. Ann Allergy Asthma Immunol 2019;123(1):11–15.
  • Yang BC, Castells M. Medical algorithm: Diagnosis and treatment of drug hypersensitivity reactions to biologicals. Allergy 2020;75(12):3293-3296.

Vaka Raporu: Crohn Hastalığı Olan Yetişkin Bir Hastada Ustekinumab’a Karşı Başarılı İlaç Desensitizasyonu

Year 2025, Volume: 7 Issue: 3, 471 - 475, 13.10.2025
https://doi.org/10.52827/hititmedj.1675463

Abstract

Amaç: Ustekinumab, inflamatuar hastalıkların tedavisinde kullanılan biyolojik bir ajandır. Biyolojik tedaviler hedefli tedaviler olduğundan kullanımı artmakta ve buna bağlı olarak ilgili reaksiyonların görülme sıklığı artmaktadır. Bu olguyu, ustekinumab'a reaksiyon geliştiren bir hastaya uyguladığımız başarılı desensitizasyon nedeniyle sunuyoruz.
Gereç ve Yöntem: Ustekinumab'ın beşinci subkutan dozuna karşı olumsuz reaksiyon yaşayan yetişkin bir Crohn hastalığı hastası İmmünoloji ve Alerji kliniğimizde değerlendirildi.
Bulgular: Hasta, kademeli hızlı ilaç desensitizasyonu protokolü kullanılarak başarıyla tedavi edildi.
Sonuç: Bu olguyu, ilacın yaygın olarak kullanıldığı Dermatoloji, Romatoloji ve Gastroenteroloji gibi kliniklerde ilaç reaksiyonlarının yönetiminde desensitizasyonun önemini ve farkındalığını vurgulamak için sunuyoruz.

References

  • Ryan C, Thrash B, Warren RB, et al. The use of ustekinumab in autoimmune disease. Expert Opin Biol Ther 2010;10:587–604.
  • Johnson & Johnson. Content Lab. U.S. FDA Approves STELARA® [Ustekinumab] for Treatment of Adults with Moderately to Severely Active Crohn’s Disease. https://www. jnj.com/media-center/press-releases/fda-approves-stelaraustekinumab-for-treatment-of-adults-with-moderately-toseverely-active-crohns-disease (Accessed: September 4, 2021.)
  • European Medicines Agency. Stelara®.2018. https://www. ema.europa.eu/en/medicines/human/EPAR/stelara (Accessed: September 4, 2021.)
  • Yang BC, Castells MC. The who, what, where, when, why, and how of drug desensitization. Immunol Allergy Clin North Am 2022;42(2):403-420.
  • Murphy CA, Langrish CL, Chen Y, et al. Divergent pro- and anti-inflammatory roles for IL-23 and IL-12 in joint autoimmune inflammation. J Exp Med 2003;198(12):1951-1957.
  • Bavbek S, Pagani M, Alvarez-Cuesta E, et al. Hypersensitivity reactions to biologicals: an EAACI position paper. Allergy 2022;77(1):39-54.
  • Picard M, Galvao VR. Current knowledge and management of hypersensitivity reactions to monoclonal antibodies. J Allergy Clin Immunol Pract 2017;5:600-609.
  • Spencer EA, Kinnucan J, Wang J, et al. Real-World Experience with Acute Infusion Reactions to Ustekinumab at 2 Large Tertiary Care Centers. Crohns Colitis 360 2020 Apr 10;2(2):otaa022.
  • Naranjo CA, Busto U, Sellers EM, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther 1981;30(2):239-245.
  • Cohen B, Tomer G, Gavrilova T. Successful drug desensitization to ustekinumab in a patient with Crohn’s disease. Case Rep Gastroenterol 2021;15(2):657–661.
  • Torres J, Mehandru S, Colombel JF, et al. Crohn’s disease. Lancet 2017;389:1741–1755.
  • Feagan BG, Sandborn WJ, Gasink C, et al. Ustekinumab as Induction and Maintenance Therapy for Crohn’s Disease. N Engl J Med 2016;375(20):1946-1960.
  • Thomas PWA. Immediate infusion reaction to intravenous ustekinumab in three Crohn’s disease patients: a case report andreview of the literature. J Crohns Colitis 2021;15(1):162–164.
  • Cleveland NK, Masching A, Rubin DT. Hypersensitivity to IV ustekinumab but tolerance to subcutaneous ustekinumab in a patient with Crohn’s disease. Am J Gastroenterol 2018;113:1167–1168.
  • Yang BC, Castells MC. Rituximab hypersensitivity and desensitization: a personalized approach to treat cancer and connective tissue diseases. Ann Allergy Asthma Immunol 2019;123(1):11–15.
  • Yang BC, Castells M. Medical algorithm: Diagnosis and treatment of drug hypersensitivity reactions to biologicals. Allergy 2020;75(12):3293-3296.
There are 16 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Case Report
Authors

Selma Yeşilkaya 0000-0002-1841-0177

Publication Date October 13, 2025
Submission Date April 14, 2025
Acceptance Date July 7, 2025
Published in Issue Year 2025 Volume: 7 Issue: 3

Cite

AMA Yeşilkaya S. Case Report: Successful Drug Desensitization to Ustekinumab in an Adult Patient with Crohn’s Disease. Hitit Medical Journal. October 2025;7(3):471-475. doi:10.52827/hititmedj.1675463