Ustekinumab in enteropathic arthritis

Plain language summaryTreatments targeting the IL-23 pathway are highly effective in psoriasis, psoriatic arthritis and inflammatory bowel diseases. However, their efficacy in patients with enteropathic arthritis with peripheral and/or axial joint involvement is unclear. Ustekinumab may be a valuable option for patients who cannot adhere to other treatment options due to side effects or ineffectiveness. Considering its positive effects on joint involvement in patients with psoriatic arthritis, the current work was designed to investigate the efficacy of ustekinumab in patients with enteropathic arthritis on both gut and extraintestinal involvement, particularly musculoskeletal symptoms. Objective: The aim of this study was to evaluate the efficacy of ustekinumab in the treatment of enteropathic arthritis. Materials & methods: A systematic literature search was performed in the Pubmed database of publications between January 2010 and October 2021. Demographic characteristics, comorbidities, inflammatory bowel disease and enteropathic arthritis symptoms, other extraintestinal findings, medical treatments and clinical and laboratory findings for all cases were recorded. Results: A total of 11 patients were included. While clinical and laboratory remission was achieved in terms of inflammatory bowel disease in all patients and enteropathic arthritis in nine patients after ustekinumab treatment, other extraintestinal findings for all patients completely regressed after treatment. Conclusion: Ustekinumab may be an appropriate treatment option for this patient group, considering both pathogenesis and successful treatment responses. Tweetable abstractUstekinumab is a biological agent blocking the IL-12/23 pathway. Considering its effectiveness in psoriatic arthritis and inflammatory bowel disease, it may also be an option for enteropathic arthritis.