Psoriasis is a chronic inflammatory disease which has traditionally been treated with topical agents, phototherapy and oral medicines. Stelara® (ustekinumab) offers a more targeted approach by inhibiting T-cell mediated inflammatory processes. Stelara® is a monoclonal antibody that binds to interleukins 12 and 23, preventing them from activating T-cells.
The dosage is 45mg (90mg for patients >100kg) subcutaneously at 0 weeks, 4 weeks and every 12 weeks thereafter. Studies have shown that over 70% of Stelara® patients achieve a 75% improvement in their symptoms. Efficacy is more modest for psoriatic arthritis, with 12-14% of clinical trial participants achieving a 70% improvement. Post marketing surveillance suggests that these benefits are maintained with long-term use.
Due to its immunosuppressant effects, Stelara® can increase the risk of infections and malignancies.
- Leonardi CL, Kimball AB, Papp KA, Yeilding N, Guzzo C, Wang Y et al. Efficacy and safety of ustekinumab, a human interleukin-12/23 monoclonal antibody, in patients with psoriasis:76-week results from a randomised, double-blind, placebo-controlled trial (PHOENIX 1). Lancet 2008; 371:1665-74.
- Stelara (ustekinumab) Australian Approved Product Information, Macquarie Park: Janssen-Cilag Pty Ltd. Approved 28 July 2009, amended 25 February 2015.