Stelara® (ustekinumab) is a biologic medication for the treatment of moderate to severe plaque psoriasis.
It is the first of a new type of “biologic” medication that provides effective relief of psoriasis symptoms with infrequent dosing.
Stelara® is approved by the FDA to treat adults 18 years and older with psoriasis that involves large areas or many areas of their body, who are candidates for other systemic treatments, such as methotrexate, cyclosporine or phototherapy.
Dr. Jeffrey Poole – Poole Dermatology
“The age of biologics has made a tremendous impact on the care of psoriasis. These medicines have opened up a new world of safe and effective treatments for our worst psoriasis sufferers. They are often my first choice for “whole body” and/or lifestyle affecting psoriasis, where topical therapies just can’t do the job or aren’t practical.
Stelara® is a nice addition to our current treatment options. It offers a novel mechanism of action, so patients that have perhaps failed other biologics in the past, have hope with this drug. It also offers less frequent dosing than our other options, essentially every 12 weeks after the initial induction phase.
Our primary concern with Stelara® right now is the lack of long term safety data, relative to the other biologic and non-biologic therapies. Safety, before efficacy, needs to be our first goal.
Currently, I am comfortable with Stelara® as a 2nd line biologic agent for patients that have failed one of my first options, or as a first line option if their medical history suggests Stelara® would be safer.”
Visit Dr. Poole’s website at Poole Dermatology.
Dr. Eliot Mostow – Akron Dermatology
“In my experience, Stelara® is generally very effective at controlling psoriasis symptoms.
I may prescribe Stelara® to my patients with psoriasis in the following circumstances:
- When a psoriasis patient warrants treatment with a biologic, I often start with a TNF-alpha inhibitor, such as Enbrel® or Humira®. I may prescribe Stelara® if these medications do not provide sufficient control of psoriasis symptoms.
- Since Stelara® is administered in our office a few times a year, I may also consider prescribing Stelara® to those who may benefit from not having to deal with giving themselves injections at home.
One of the advantages of this biologic medication (an IL-12/23 inhibitor) is that it is given at once when initiating treatment, again one month later, and then every 3 months after that. This means that the patient receives only 4 injections in the first year of treatment.”
Visit Dr. Mostow’s website at Akron Dermatology.
Dr. Aaron Pace – Pace Dermatology Associates
“Stelara® is useful for patients that have tried other biologics and failed.
It also requires less injections and may be better for people who cannot treat themselves since they are given in the physician’s office.”
More About Stelara® (ustekinumab)
How Does Stelara® Work?
Stelara® (ustekinumab) treats psoriasis through a unique mechanism of action. it blocks interleukin-12 (IL-12) and interleukin-23 (IL-23). These are proteins that are part of the immune system that can lead to inflammation. Reducing the activity of IL-12 and IL-23 reduces inflammation in the skin and slows the growth of skin cells.
Other biologic medications block different parts of the immune system, such as a protein called “tumor necrosis factor” (TNF). Medications that block TNF (“TNF inhibitors”) include Enbrel®, Humira® and Remicade®.
How is Stelara® Administered?
Unlike some biologic medications that may be self-injected at home, Stelara® should be administered by a medical professional. Each injection is given under the skin using a small needle.
Stelara® is given twice in the first month. These are called the “starter doses”. These starter doses are followed by injections every 12 weeks, or just four times per year. The relatively long duration of relief between treatments (only 5 doses per year) is one of the benefits of Stelara®.
The injection will be given in an area that is unaffected by plaque psoriasis. The location of the injection may differ each time.
Stelara® is available in 45 mg or 90 mg doses. Your doctor will determine the dose that is right for you. Generally, those individuals weighing less than 220 pounds receive doses of 45 mg. Those weighing more than 220 pounds, usually receive the 90 mg dosing. Your doctor will prescribe the right dose of Stelara® for you.
Your doctor will determine how long you will need to continue treatment with Stelara®.
How Effective is Stelara®?
Three clinical studies of 2,266 psoriasis patients showed Stelara® to be safe and effective for the treatment of moderate to severe psoriasis.
In a medical study, 7 out of 10 people taking Stelara® saw at least 75% clearer skin at 12 weeks, and 6 out of 10 patients had their plaque psoriasis rated as cleared or minimal at 12 weeks. These improvements were measured by the PASI score and other clinical outcomes
In another medical study, clearance of psoriasis lesions was maintained at one year in most patients who initially responded to Stelara® and continued to receive treatment.
The safety and effectiveness of Stelara® have not been evaluated beyond two years. Individual results may vary.
Discuss any questions you have with your doctor.
Stelara® is a registered trademark of Janssen Biotech, Inc.