Abstract

BRICENO-CASADO, MP  and  GIL-SIERRA, MD. Therapeutic management of Crohn's disease in pregnancy and obesity. Rev. OFIL·ILAPHAR [online]. 2022, vol.32, n.3, pp.307-308.  Epub Sep 25, 2023. ISSN 1699-714X.  https://dx.doi.org/10.4321/s1699-714x20220003000018.

Crohn's disease (CD) is an inflammatory bowel disease (IBD) that affects any part of gastrointestinal tract, in the form of acute events and relapses. Ustekinumab is an interleukin IL-12/23 inhibitor monoclonal antibody authorised for the treatment of moderate-severe CD. There is an increasing number of obese patients with IBD, which is associated with worse response to biologic therapy, increased risk of relapse and complexity of surgical treatment. Bariatric surgery –an effective treatment for severe obesity that improves associated comorbidities– is related with high risk in patients with IBD. Treatment of IBD in pregnant women is also a challenge, requiring a multidisciplinary management and optimal disease management both before and during pregnancy. The label for ustekinumab describes insufficient data of safety during pregnancy and recommends to avoid its use. This case describes the treatment of CD in an obese and pregnant patient, two special situations in which the benefit-risk balance is essential in therapeutic decision-making and for which further development of scientific evidence is needed. About biologic treatments received by the patient, ustekinumab safely achieved and symptom control.

Keywords : Crohn's disease; pregnancy; obesity; ustekinumab.

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