Ustekinumab is now recommended, either alone or in combination with methotrexate, in adults when:
- treatment with tumour necrosis factor (TNF) inhibitors is contraindicated but would otherwise be considered or
- the person has already been treated with a TNF inhibitor
NICE technology appraisal TA340
If there is inadequate improvement in the patient's condition according to the Psoriatic Arthritis Response Criteria (PsARC) at 24 weeks, ustekinumab treatment should be stopped. Patients who experience a Psoriasis Area and Severity Index (PASI) 75 response, but whose PsARC response does not justify continuing treatment, should be assessed by a dermatologist to determine whether ongoing treatment is appropriate on the basis of skin response.
Acceptance by NICE is conditional on the manufacturer providing the 90mg dose of ustekinumab for people who weigh more than 100kg at the same cost as the 45mg dose, as agreed in the patient access scheme.
Ustekinumab is administered by subcutaneous injection. It binds to and inhibits interleukins 12 and 23.