Hypersensitivity to IV Ustekinumab but Tolerance to Subcutaneous Ustekinumab in a Patient With Crohns Disease

摘要

Ustekinumab is a monoclonal antibody against the p40 subunit of interleukin (IL)-12 and IL-23 and is US Food and Drug Administration (FDA)-approved for plaque psoriasis, moderately to severely active Crohn's disease, and ulcerative colitis. We describe a case of an immediate hypersensitivity reaction to ustekinumab infusion with no reaction to subsequent ustekinumab subcutaneous maintenance therapy. We identify ethylenediaminetetraacetic acid as a unique excipient found in the intravenous formulation compared with the prefilled syringe used for subcutaneous injections, which is likely to account for this observation. No similar cases have been reported in the literature.