Understanding the Medication Stelara (Ustekinumab)
Living with a chronic inflammatory condition like psoriasis or Crohn's disease can be a constant challenge, marked by unpredictable flares and persistent discomfort. For many years, treatment options were limited, but the development of biologic medications has been a game-changer. One such medication is Stelara (active ingredient: ustekinumab).
If you or a loved one are considering or have recently started this treatment, here is a breakdown of what Stelara is, how it works, and what you should know about it.
What is Stelara and What Does It Treat?
Stelara is a biologic medication, a type of drug derived from living organisms, specifically a monoclonal antibody. It's approved by the FDA for the treatment of several chronic inflammatory diseases:
- Moderate to Severe Plaque Psoriasis (in adults and children 6 years and older)
- Active Psoriatic Arthritis (in adults and children 6 years and older)
- Moderate to Severely Active Crohn's Disease (in adults)
- Moderate to Severely Active Ulcerative Colitis (in adults)
It is not a cure, but it is highly effective in managing the symptoms, reducing inflammation, and helping patients achieve remission.
The Mechanism of Action: Targeting the Root Cause
Unlike older systemic treatments that broadly suppress the immune system, Stelara is designed to be highly targeted. It works by addressing specific proteins in the immune system that drive inflammation in these conditions.
Stelara selectively targets and blocks two key inflammatory proteins, or cytokines, called interleukin-12 (IL-12) and interleukin-23 (IL-23).
These interleukins are naturally-occurring substances that play a central role in the inflammatory cascade. By binding to a shared subunit of these proteins, Stelara prevents them from communicating and activating certain T-cells that lead to the overactive inflammation seen in psoriasis, psoriatic arthritis, Crohn's disease, and ulcerative colitis.
In simple terms, it acts as a very specific roadblock to a major inflammation pathway, helping to reset the immune system's balance.
How is Stelara Administered?
Stelara is an injectable medication, but the delivery method and frequency vary depending on the condition being treated:
- For Plaque Psoriasis and Psoriatic Arthritis: The treatment usually begins with a subcutaneous injection (under the skin) at Week 0, followed by another dose at Week 4. After that, the treatment moves to a maintenance phase with an injection every 12 weeks.
- For Crohn's Disease and Ulcerative Colitis: The first dose is typically given as an intravenous (IV) infusion in a clinic setting (the "induction dose"). This is followed by a maintenance dose, a subcutaneous injection, usually 8 weeks later and every 8 weeks thereafter.
Your doctor will determine the appropriate dose and schedule for your specific needs, sometimes based on your body weight.
Important Safety Information: What to Discuss with Your Doctor
As with any powerful medication that affects the immune system, there are potential side effects and precautions to be aware of. Before starting Stelara, your healthcare provider will likely:
- Test for Tuberculosis (TB): Since Stelara can lower your ability to fight infections, a TB test is required, and treatment for latent TB may be necessary before starting Stelara.
- Screen for Hepatitis B and other chronic infections.
Common side effects often include upper respiratory infections (like the common cold), headache, fatigue, and redness or pain at the injection site.
Serious side effects are less common but possible and can include:
- Serious Infections: Because it suppresses part of the immune system, Stelara can increase the risk of serious infections.
- Cancers: A slight increase in the risk of certain cancers, particularly non-melanoma skin cancer, has been reported.
- Allergic Reactions: Serious allergic reactions are rare but require immediate medical attention.
It is crucial to tell your doctor right away if you develop any signs of infection (such as fever, persistent cough, or flu-like symptoms) or any new or changing skin growths.
The Takeaway
Stelara has offered a new path to a better quality of life for many patients grappling with chronic inflammatory diseases. Its targeted approach to blocking IL-12 and IL-23 is a testament to the advances in modern medicine.
If you are considering Stelara, have an open and thorough conversation with your healthcare provider. Discuss your full medical history, all the medications you are currently taking, and any concerns you may have. Together, you can determine if Stelara is the right treatment to help you find relief and manage your condition effectively.