Ustekinumab
Ustekinumab is a biologic medication that is used to treat severe psoriasis and/or psoriatic arthritis. It is known by the brand names Stelara, Steqeyma, Pyzchiva, Uzpruvo and Wezenla.
Please note: Previously, Stelara had patent exclusivity for Ustekinumab, but as of 19th July 2024 the patent exclusivity expired. Additional biosimilar Ustekinumab brands are now available.
Ustekinumab blocks the activity of interleukin 12 (IL-12) and interleukin 23 (IL-23), chemical ’messengers’ in the immune system that signal other cells to cause inflammation. In people with psoriasis or psoriatic arthritis, the immune system is overactive and creates too much inflammation, which leads to the development of psoriasis and psoriatic arthritis symptoms. By blocking IL-12 and IL-23, Ustekinumab aims to prevent some of that inflammation from occurring, leading to an improvement in psoriasis or psoriatic arthritis for some people who take it.
Ustekinumab can be prescribed to treat severe plaque psoriasis in adults and children over the age of six. Usually it will only be offered to people who have not responded to, or cannot take non-biologic systemic treatments including ciclosporin, methotrexate or PUVA light therapy.
Ustekinumab can also be prescribed to treat active and ‘progressive’ (worsening) psoriatic arthritis if other disease-modifying anti-rheumatic drugs have not worked. This includes other ‘anti-TNF’ biologic treatments that are available for psoriatic arthritis. This means that if you have taken systemic treatments such as methotrexate, sulfasalazine or leflunomide, or biologic treatments such as Simponi (Golimumab), Adalimumab (Humira, Amgevita, Hulio, Hyrimoz, Idacio and Imraldi), Etanercept (Enbrel and Benepali) or Infliximab (Remicade, Flixabi, Remsima, Zessly and Inflectra) for your psoriatic arthritis without a good response, you could be offered Ustekinumab.
Individuals take Ustekinumab at home by giving themselves an injection under the skin via a pre-filled ‘pen’ device or pre-filled syringe. Most people will be trained by a nurse to give the injection to themselves. The first doses are taken four weeks apart, but after that Ustekinumab is usually taken every 12 weeks. Ustekinumab can be prescribed by itself or is sometimes used in combination with methotrexate.
People taking Ustekinumab will have regular blood tests every three to six months- usually carried out by Dermatology Nurses, or by their own GP - to monitor for infections or other possible effects of the treatment. People taking Ustekinumab should have an annual flu jab, but should check with a doctor or nurse before having any other vaccinations or taking other medication.
It can take a number of weeks before a person’s psoriasis or psoriatic arthritis improves on Ustekinumab. If considerable improvement is not seen in four months, treatment with Ustekinumab will be stopped. If this happens, a Dermatologist or Rheumatologist should discuss the next available options with you - there are a number of other biologic or systemic treatments that can be tried if Ustekinumab does not work.
How safe and effective is Ustekinumab?
Ustekinumab has been used to treat psoriasis in the UK since 2009. ‘Real-world’ safety and effectiveness data is being compiled by the British Association of Dermatologists Biologics Interventions Register (BADBIR). It is recommended that all people taking biologic treatments for their psoriasis should be asked for their data to be included in this register.
The information on this page is also available in our Ustekinumab information sheet.