Leitura clínica
Comentário
Anticorpo monoclonal humano IgG1 que se une às interleucinas 12 e 23. É utilizado no tratamento da psoríase em placas grave, da artrite psoriásica e da doença de Crohn e colite ulcerativa. Administração intravenosa e subcutânea a cada 12 semanas. Seus dados farmacocinéticos (peso molecular muito elevado e amplo volume de distribuição) explicam a passagem ínfima para o leite materno observada. (Saito 2022, Bar-Gil 2021, Klenske 2019, Matro 2018) Não foram observados problemas clínicos nem maior taxa de infecções nem problemas com as vacinações rotineiras em lactentes de mães em tratamento com este fármaco. (Saito 2022, Bar-Gil 2021, Klenske 2019, Mugheddu 2019, Matro 2018) Por sua natureza proteica, é inativado no trato gastrointestinal, não sendo absorvido (biodisponibilidade oral praticamente nula), o que dificulta ou impede a passagem para o plasma do lactente a partir do leite materno ingerido (Lactmed, Rademaker 2018, Bragnes 2017, Götestam 2016, Mervic 2014, Witzel 2014, Butler 2014) , exceto em prematuros e no período neonatal imediato, nos quais pode haver maior absorção intestinal. (Sammaritano 2020) Não foram detectados problemas em lactentes cujas mães recebiam outros anticorpos monoclonais similares, como belimumab, bevacizumab, infliximab, ituximab, tocilizumab ou ustekinumab. (Bar-Gil 2021, LaHue 2020, Saito 2020, 2019 and 2018, Klenske 2019, Mugheddu 2019, Krysko 2019, Matro 2018, Bragnes 2017, Hyrich 2014, Danve 2014) Diversas sociedades médicas, autores especialistas e consensos de especialistas consideram compatível ou provavelmente compatível o uso desta medicação durante a amamentação. (Lactmed, Hale, Bar-Gil 2021, Laube 2021, Gisbert 2020, Sammaritano 2020, Lamb 2019, Picardo 2019, Mahadevan 2019, Amin 2018, Götestam 2016, McConnell 2016) Dada a forte evidência existente sobre os benefícios da amamentação materna para o desenvolvimento dos bebês e a saúde das mães, convém avaliar o risco-benefício de qualquer tratamento materno, assessorando individualmente cada mãe que deseje seguir com a amamentação. (Koren 2013)
Encontrabilidade
Outros nomes e marcas
Sinônimos e grafias 6
- Inmunoglobulina G1 CNTO-1275
- أوستيكينوماب
- Устекинумаб
- 乌司奴单抗
- ウステキヌマブ
- L04AC05
Marcas comerciais na fonte 2
- Stelara
- Stelara (Стелара)
Dados da fonte
Farmacocinética
| Variável | Valor | Unidade |
|---|---|---|
| Biodisp. oral | 0 | % |
| Peso Molecular | 148.600 | daltons |
| Vd | 0,06 - 0,16 | l/Kg |
| Tmax | 168 - 324 | horas |
| T½ | 480 (360 - 768) | horas |
| Índice L/P | 0,001 - 0,027 | - |
| Dosis Teórica | 0,0005 - 0,24 | mg/Kg/d |
Rastreabilidade
Bibliografia
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