FDA approved ustekinumab (Stelara) for plaque psoriasis. Here, a quick overview:
In the last few years biologic therapy has shown promise in the treatment of psoriasis. Many TNF blockers (adalimumab, etanercept, infliximab) are now indicated in severe cases that do not respond to other therapies.
On September 25, 2009 the U.S. FDA approved ustekinumab (Stelara, manufactured by Centocor Ortho Biotech Inc, a subsidiary of Johnson & Johnson) for the treatment of plaque psoriasis.
Ustekinumab is a monoclonal antibody that targets IL-12 and IL-23, and it is administered by subcutaneous route.
The UK’s National Institute for Health and Clinical Excellence issued a guidance that recommended ustekinumab use in the following clinical setting:
Severe psoriasis that has not responded to standard systemyc therapies including ciclosporin, methotrexate and PUVA(psoralen and long-wave ultraviolet radiation). Ustekinumab (Stelara), may also be considered in patients intolerant or have a contraindication to these treatments.
Ustekinumab (Stelara) mechanism of action in psoriasis
The figure shows how ustekinumab (CNTO) blocks interleukin 12 (IL-12) and interleukin 23 (IL-23), these cytokines are involved in T-cell activation and promote immune response.
Efficacy and safety of ustekinumab in patients with psoriasis: PHOENIX 1 and PHOENIX 2 trials. National electronic Library for Medicines, NHS.
Review: Treatments for psoriasis and risk of malignancy. National electronic Library for Medicines, NHS.