Stelara 130 mg Injection
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Description
Stelara (ustekinumab) is a fully human monoclonal antibody that targets the p40 subunit shared by interleukins IL-12 and IL-23, key drivers of inflammation. Available as a 130 mg single-dose IV infusion (loading dose) and 45/90 mg subcutaneous injection, Stelara is used to treat several immune-mediated inflammatory conditions.
Benefits
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Rapid and durable skin clearance: Many psoriasis patients achieve significant improvement by week 12
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Effective long-term maintenance: Over 50% of ulcerative colitis patients maintained remission through 4 years
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Convenient dosing: After initial loading, subcutaneous injections every 8–12 weeks, reducing treatment burden compared to more frequent biologics
Indications and Usage
Stelara is FDA-approved for:
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Moderate to severe plaque psoriasis in adults and children (≥ 6 yrs)
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Active psoriatic arthritis in adults and children (≥ 6 yrs)
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Moderate to severe Crohn’s disease and ulcerative colitis in adults
How it Works
Ustekinumab binds to the p40 subunit of IL-12 and IL-23, thereby preventing these cytokines from activating immune responses. By blocking IL‑12/IL‑23 pathway activation of Th1/Th17 cells, it reduces inflammation and halts tissue damage in psoriasis and IBD.
Dosage & Administration
For Crohn’s disease / ulcerative colitis:
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Initial IV infusion 130 mg (or weight-based 260–520 mg)
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Followed by SC injection of 90 mg every 8 weeks
For psoriasis / psoriatic arthritis:
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45 mg SC at Week 0, Week 4, then every 12 weeks
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90 mg dose recommended for adults weighing > 100 kg for enhanced response
Injection sites include the upper arm, thigh, abdomen, or buttocks. IV infusions take at least 1 hour
Side Effects
Common (≥ 4%)
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Upper respiratory infections (“common cold”), headache, injection-site reactions
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Itchy skin, nausea, vomiting, bronchitis, sinus infections, urinary tract infections, vaginal yeast infections
Serious (less common)
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Increased risk of infections; monitor for signs of TB and serious bacterial/fungal infections
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Hypersensitivity reactions, possible malignancy risk from immunosuppression
Warning and Precaution
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Infection risk: Screen for tuberculosis before initiating therapy
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Hypersensitivity: Monitor during and after the first dose
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Malignancy: Long-term immunosuppression may slightly increase the risk
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Live vaccines: Avoid during treatment
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Follow medical guidance when switching to biosimilars (e.g., Selarsdi/Otulfi)
Clinical Trial & Approvals
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FDA first approved in 2009 for plaque psoriasis, expanded for psoriatic arthritis (2013), Crohn’s disease (2016), and ulcerative colitis (2019)
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Long-term UC data: over half of patients maintained remission at 4 years
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Multiple biosimilars (e.g., Selarsdi, Otulfi, Pyzchiva) are now FDA-approved interchangeable versions
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