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Facts about the skin from DermNet New Zealand Trust. Topic index: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z


What is ustekinumab?

Ustekinumab (STELARA™) is a biological treatment used to treat moderate to severe psoriasis. It is a human monoclonal antibody that antagonises interleukin-12 (IL-12) and IL-23. Good to excellent responses are seen in more than two-thirds of patients with chronic plaque psoriasis treated with ustekinumab.

Ustekinumab has been shown in small studies to be useful in other forms of psoriasis, including nail psoriasis, erythrodermic psoriasis and palmoplantar pustulosis. It is under investigation in the treatment of psoriatic arthritis and Crohn disease.

Erythrodermic psoriasis before ustekinumab Erythrodermic psoriasis 2 weeks after first dose of ustekinumab
Erythrodermic psoriasis before and 2 weeks after a single dose of ustekinumab

How does ustekinumab work in psoriasis?

Psoriasis is caused by an increase in the production of T-cells and is influenced by cytokines, the chemical messengers produced by cells. Certain cytokines cause skin cells to grow rapidly, producing plaques of psoriasis. Ustekinumab is a monoclonal antibody that targets the p40 subunit of the cytokines IL-12 and IL-23, preventing them from binding and activating T-lymphocytes.

Dosing of ustekinumab

Ustekinumab is given by subcutaneous injection. The second dose is given 4 weeks after the first injection, and further doses are delivered every 12 weeks. It reaches its peak effect at around 28 weeks.

Adverse events due to ustekinumab

To date adverse infections are consistent with that seen with other biologics.

Precautions when considering ustekinumab

Drug interactions with ustekinumab

Use in specific populations

Pregnancy Category B

There are no studies of ustekinumab in pregnant women. Ustekinumab should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Nursing mothers

Caution should be exercised when ustekinumab is administered to a nursing woman. The unknown risks to the infant from gastrointestinal or systemic exposure to ustekinumab should be weighed against the known benefits of breast-feeding.

Paediatric use

Safety and effectiveness of ustekinumab in children have not been evaluated.

Hepatic and renal impairment

No pharmacokinetic data are available in patients with liver or kidney disease treated with ustekinumab.

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Author: Anoma Ranaweera B.V. Sc; PhD (Clinical Biochemistry, University of Liverpool, UK). Reviewed and revised by Hon A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand. September 2014.


The New Zealand approved datasheet is the official source of information for this prescription medicine, including approved uses and risk information. Check the New Zealand datasheet on the Medsafe website.

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