Description

Stelara: Comprehensive Overview

What is Stelara?

Stelara (generic name: ustekinumab) is a monoclonal antibody medication developed by Janssen Pharmaceuticals. It is used to treat:

• Crohn’s Disease (CD)
• Ulcerative Colitis (UC)
• Plaque Psoriasis
• Psoriatic Arthritis

Stelara targets interleukin-12 and interleukin-23, proteins that regulate the immune system and inflammatory disorders. It is administered either via intravenous infusion or subcutaneous injection.

Dosage and Administration

• Dosage: 45 mg to 90 mg, based on body weight.
• Initial Doses: Administered at weeks 0 and 4.
• Maintenance Doses: Administered every 8–12 weeks, adjusted based on patient response.
• Administration: By a healthcare provider or self-administered after training.

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Precautions

1. Infection Risk:
   • Stelara lowers immune system activity, increasing susceptibility to infections.
   • Report signs such as chest infections, shingles, fever, or flu-like symptoms immediately.
2. Cancer Risk:
   • Reduced immune response may increase the risk of cancers like skin cancer.
   • Notify your healthcare provider of unusual skin growths or sores.
3. Neurological Symptoms:
   • Report headaches, seizures, vision changes, or confusion, which could indicate posterior reversible encephalopathy syndrome (PRES).
4. Allergic Reactions:
   • Seek immediate medical attention for symptoms like facial swelling, severe rash, or chest tightness.
5. Inflammation:
   • Persistent rash, shortness of breath, or cough may indicate serious inflammation.

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Common Side Effects

• Nasal congestion, sore throat, or runny nose
• Upper respiratory or sinus infections
• Fever, headache, tiredness
• Redness or swelling at the injection site
• Nausea, vomiting, or diarrhea
• Vaginal yeast infections or urinary tract infections
• Joint pain or stomach pain

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Conditions Treated by Stelara

1. Crohn’s Disease (CD):
   • Symptoms: Diarrhea, abdominal pain, fatigue, weight loss, and fistulas.
   • Diagnosis: Blood tests, fecal exams, colonoscopy, CT, or MRI scans.
2. Ulcerative Colitis (UC):
   • Symptoms: Bloody diarrhea, rectal bleeding, abdominal pain, weight loss, and fatigue.
   • Diagnosis: Colonoscopy and imaging tools.
3. Plaque Psoriasis:
   • Symptoms: Raised, scaly plaques on elbows, knees, and scalp.
   • Cause: Autoimmune factors and genetic predisposition.
4. Psoriatic Arthritis:
   • Symptoms: Inflammation in joints and connective tissue, dactylitis, spondylitis, and sacroiliitis.

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How Stelara Works

Stelara inhibits interleukin-12 and interleukin-23, reducing overactive immune responses and controlling inflammation.

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Using the Stelara Syringe

1. Preparation:
   • Read the Medication Guide and instructions thoroughly.
   • Check for latent tuberculosis (TB) with a skin test before starting.
2. Injection Guidelines:
   • For psoriasis and psoriatic arthritis: Inject under the skin, once every 3 months after initial doses.
   • For Crohn’s disease and ulcerative colitis: Start with intravenous injection, followed by subcutaneous injections every 8 weeks.
3. Best Practices:
   • Rotate injection sites (upper arms, thighs, buttocks, or abdomen).
   • Do not inject into irritated or infected skin.
   • Use a colorless to light-yellow solution; discard discolored solutions.

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Consultation and Monitoring

• Inform your healthcare provider of severe or persistent symptoms.
• Regular monitoring ensures effective treatment and minimizes risks.

Precautions for Surgery and Vaccinations

• Avoid live vaccines during treatment.
• Inform your doctor of all medications before surgery.

Pregnancy and Breastfeeding

• Use during pregnancy or breastfeeding only if necessary, as advised by your doctor.

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Side Effects to Watch For

• Persistent injection site reactions.
• Signs of infection: fever, flu, or worsening pain.
• Rare conditions: PRES, cancer, or severe allergic reactions.