What is Ustekinumab: Uses, Dosage, Side Effects and More

Ustekinumab is a prescription medication that helps calm an overactive immune system. It belongs to a class of drugs called biologics, which are made from living cells and work by targeting specific proteins that cause inflammation in your body.

This medication is particularly effective for people with autoimmune conditions where the immune system mistakenly attacks healthy tissues. Think of it as a targeted therapy that helps restore balance to your immune response rather than suppressing your entire immune system.

What is Ustekinumab Used For?

Ustekinumab treats several autoimmune conditions where inflammation plays a central role. Your doctor might prescribe it when other treatments haven't provided enough relief or when you need a more targeted approach to managing your condition.

The medication is FDA-approved for treating moderate to severe plaque psoriasis, a skin condition that causes raised, scaly patches. It's also used for psoriatic arthritis, which affects both your skin and joints, causing pain and stiffness.

Additionally, ustekinumab helps manage Crohn's disease and ulcerative colitis, two forms of inflammatory bowel disease that cause chronic inflammation in your digestive tract. These conditions can significantly impact your quality of life, and ustekinumab offers hope for better symptom control.

How Does Ustekinumab Work?

Ustekinumab works by blocking specific proteins called interleukin-12 and interleukin-23, which are key players in triggering inflammation. These proteins normally help your immune system fight infections, but in autoimmune diseases, they become overactive and cause harmful inflammation.

By blocking these proteins, ustekinumab helps reduce the inflammatory response that leads to symptoms like skin plaques, joint pain, and digestive tract inflammation. This targeted approach makes it a relatively strong medication that can provide significant relief for many people.

The medication doesn't cure these conditions, but it can help control symptoms and slow disease progression. Many people experience improvements in their symptoms within 12 to 16 weeks of starting treatment.

How Should I Take Ustekinumab?

Ustekinumab is given as an injection, either under your skin (subcutaneous) or into a vein (intravenous). Your doctor will determine which method is best for you based on your specific condition and treatment goals.

For subcutaneous injections, you'll typically receive the medication every 8 to 12 weeks after an initial loading phase. Your healthcare provider will teach you how to give yourself these injections at home, or they may be administered in a clinical setting.

Intravenous infusions are usually given in a healthcare facility and take about one hour to complete. The frequency depends on your condition, but it's typically every 8 weeks after the initial doses.

You can take ustekinumab with or without food, as it doesn't affect how well the medication works. However, it's important to keep your injection sites clean and rotate them to prevent irritation.

How Long Should I Take Ustekinumab For?

Ustekinumab is typically a long-term treatment, and most people need to continue taking it indefinitely to maintain symptom control. Your doctor will monitor your response to the medication and may adjust your treatment plan over time.

You might start seeing improvements within 4 to 6 weeks, but the full benefits often take 12 to 16 weeks to become apparent. Some people experience even more improvement after several months of treatment.

Your doctor will regularly assess whether the medication is working effectively for you. If you're not seeing adequate improvement after 16 weeks, they might consider adjusting your dose or exploring alternative treatments.

What Are the Side Effects of Ustekinumab?

Like all medications, ustekinumab can cause side effects, though many people tolerate it well. Understanding what to expect can help you feel more confident about your treatment and know when to contact your healthcare provider.

Common side effects you might experience include:

• Upper respiratory tract infections like colds or sinus infections
• Headaches that are usually mild to moderate
• Fatigue or feeling more tired than usual
• Injection site reactions such as redness, swelling, or mild pain
• Nausea or mild stomach upset
• Back pain or muscle aches

These common side effects are generally manageable and often improve as your body adjusts to the medication.

More serious side effects can occur, though they're less common. These require immediate medical attention and include:

• Signs of serious infections like fever, chills, or persistent cough
• Unusual changes in your skin, such as new growths or changes in existing moles
• Severe allergic reactions including difficulty breathing or swelling of your face
• Symptoms of inflammatory bowel disease flare-ups if you have Crohn's disease
• Neurological symptoms like confusion, vision changes, or severe headaches

Rare but serious side effects include an increased risk of certain cancers and severe infections. Your doctor will monitor you closely for these potential complications through regular check-ups and blood tests.

Who Should Not Take Ustekinumab?

Ustekinumab isn't suitable for everyone, and your doctor will carefully evaluate whether it's right for you. Certain medical conditions and circumstances make this medication inappropriate or require special monitoring.

You should not take ustekinumab if you have an active infection, especially serious infections like tuberculosis or hepatitis B. Your doctor will test for these conditions before starting treatment.

People with a history of cancer, particularly lymphoma or skin cancer, need careful evaluation before using ustekinumab. The medication can affect your immune system's ability to detect and fight cancer cells.

If you're pregnant or breastfeeding, discuss the risks and benefits with your doctor. While ustekinumab may be used during pregnancy in certain situations, it requires careful monitoring.

Those with severe liver or kidney disease may need dose adjustments or alternative treatments. Your doctor will consider your overall health status when determining if ustekinumab is appropriate for you.

Ustekinumab Brand Names

Ustekinumab is available under the brand name Stelara, which is manufactured by Janssen Biotech. This is the most commonly prescribed form of the medication.

The biosimilar version, ustekinumab-auub, is marketed under the brand name Wezlana. Biosimilars are highly similar to the original medication but may have slight differences in inactive ingredients.

Both versions work essentially the same way and have similar effectiveness and safety profiles. Your doctor and insurance provider will help determine which option is best for your specific situation.

Ustekinumab Alternatives

Several alternative medications are available if ustekinumab isn't suitable for you or doesn't provide adequate symptom control. These alternatives work through different mechanisms but target similar inflammatory pathways.

Other biologic medications include adalimumab (Humira), infliximab (Remicade), and secukinumab (Cosentyx). Each has its own benefits and potential side effects, and your doctor will help you choose the most appropriate option.

Non-biologic alternatives include methotrexate, sulfasalazine, and various topical treatments for skin conditions. These medications work differently and may be combined with biologics for enhanced effectiveness.

Your doctor will consider factors like your specific condition, previous treatment responses, and overall health when recommending alternatives. Sometimes trying different medications helps find the most effective treatment for your individual needs.

Is Ustekinumab Better Than Adalimumab?

Both ustekinumab and adalimumab are effective biologic medications, but they work through different mechanisms and may be better suited for different people. Neither is universally better than the other.

Ustekinumab blocks interleukin-12 and interleukin-23, while adalimumab targets tumor necrosis factor-alpha. This difference means they may work better for different types of inflammation or in people who haven't responded to one or the other.

Ustekinumab is typically given less frequently than adalimumab, which some people find more convenient. However, adalimumab has been available longer and has more extensive long-term safety data.

Your doctor will consider your specific condition, previous treatment responses, and personal preferences when choosing between these medications. Sometimes people switch from one to the other if they don't achieve adequate symptom control.