Psoriatic Arthritis treatments: Biologics

Risankizumab is a biological medicine used to treat adults with active psoriatic arthritis. It may be used when previous treatment with one or more disease-modifying antirheumatic drugs (DMARDs) has not worked well enough or has not been tolerated.

Risankizumab can be used on its own or in combination with other medicines used to treat psoriatic arthritis.

How does it work?

Risankizumab is a biological medicine that specifically blocks a protein called interleukin-23 (IL-23). IL-23 plays an important role in causing inflammation in psoriasis and psoriatic arthritis.

By blocking IL-23, risankizumab reduces inflammation and can help improve symptoms such as joint pain, stiffness and swelling. It can also improve psoriasis affecting the skin and nails and may help slow the progression of joint damage.

Who can get it?

Risankizumab is available on prescription for adults with active psoriatic arthritis.

Your specialist will decide whether risankizumab is suitable for you, taking into account your previous treatments and how active your condition is.

Before treatment begins, you will usually be checked for infections, including tuberculosis (TB). Risankizumab should not normally be given to people with a clinically important active infection.

How is it used?

Risankizumab is given as an injection under the skin (subcutaneous injection).

For psoriatic arthritis, the usual dose is:

• 150 mg at week 0
• 150 mg at week 4
• followed by 150 mg every 12 weeks.

Each 150 mg dose is given as two 75 mg injections.

Your healthcare professional may teach you how to give the injections yourself, or they may be administered by a healthcare professional.

What are the side effects?

Like all medicines, risankizumab can cause side effects, although not everyone experiences them.

Very common: may affect more than 1 in 10 people

• Upper respiratory tract infections, such as a sore throat or blocked nose.

Common: may affect up to 1 in 10 people

• Tiredness
• Fungal skin infections
• Injection-site reactions, such as redness, swelling or pain
• Itching

• Headache.

Uncommon: may affect up to 1 in 100 people

• Small raised red bumps on the skin.

Because risankizumab affects part of the immune system, it can make some infections more likely. Tell your doctor if you develop signs of an infection, particularly a persistent fever, chills, night sweats, a persistent cough, shortness of breath, or painful, warm or reddened skin.

You should also tell your doctor if you have an infection before having an injection.

How do I get risankizumab?

Risankizumab is available on prescription only and is normally prescribed and monitored by a specialist.

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Risankizumab is known commercially as Skyrizi® and is marketed in the UK by AbbVie Ltd.

Reviewed: August 2026
Version ID: 2/RIS/PAT/08/26

Bimekizumab is a biologic medicine used to treat adults with active psoriatic arthritis when other disease-modifying antirheumatic drugs (DMARDs) have not worked well enough or cannot be tolerated. It can be used on its own or together with methotrexate. NICE recommends bimekizumab for certain adults with active psoriatic arthritis who have not responded adequately to previous DMARD treatment.

Bimekizumab is also used to treat moderate to severe plaque psoriasis and some other inflammatory conditions.

How does it work?

Bimekizumab is a biologic medicine called an interleukin-17 (IL-17) inhibitor. It blocks two inflammatory proteins, IL-17A and IL-17F, which play an important role in the inflammation associated with psoriatic arthritis and psoriasis.

By reducing the activity of these proteins, bimekizumab reduces inflammation. This can help improve joint pain, stiffness and swelling, as well as psoriasis affecting the skin and nails. It can also improve physical functioning and quality of life.

Who can get it?

Bimekizumab is available on prescription for adults with active psoriatic arthritis.

For NHS treatment, NICE recommends it for adults whose psoriatic arthritis has not responded well enough to DMARDs or who cannot tolerate them, and who have had two conventional DMARDs and at least one biological DMARD, or for whom TNF-alpha inhibitors are contraindicated.

It can be used on its own or with methotrexate.

How is it used?

Bimekizumab is given as an injection under the skin (subcutaneous injection).

For psoriatic arthritis, the usual dose is:

• 160 mg once every 4 weeks.

If you have psoriatic arthritis together with moderate to severe plaque psoriasis, the recommended dose is:

• 320 mg at weeks 0, 4, 8, 12 and 16, followed by 320 mg every 8 weeks.
• After week 16, if the joint response is not maintained, your doctor may consider changing the dose to 160 mg every 4 weeks.

Your doctor will assess how well the treatment is working and decide whether you should continue treatment.

What are the side effects?

Like all medicines, bimekizumab can cause side effects, although not everyone gets them.

Very common

• Upper respiratory tract infections, such as a sore throat or blocked nose.

Common

• Oral thrush (candidiasis)
• Fungal skin infections, such as athlete's foot
• Ear infections
• Cold sores (herpes simplex)
• Gastroenteritis
• Inflamed hair follicles (folliculitis)
• Headache
• Rash, dermatitis or eczema
• Acne
• Injection-site reactions, such as redness, swelling or pain
• Feeling tired (fatigue).

Uncommon

• Reduced levels of certain white blood cells (neutropenia)
• Fungal infections affecting the skin or mucous membranes, including the oesophagus
• Conjunctivitis
• Inflammatory bowel disease.

Serious allergic reactions, including anaphylaxis, have been reported with IL-17 inhibitors. Seek urgent medical attention if you develop symptoms of a serious allergic reaction, such as swelling of the face, lips, tongue or throat, difficulty breathing or severe dizziness.

Because bimekizumab affects part of the immune system, your doctor will check for infections and other relevant health problems before and during treatment.

How do I get bimekizumab?

Bimekizumab is available on prescription and is normally started and monitored by a healthcare professional experienced in treating psoriatic arthritis.

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Bimekizumab is known commercially as Bimzelx and is marketed in the UK by UCB Pharma Ltd

Reviewed: August 2026
Version ID: 2/BIM/PAT/08/26

Adalimumab is a biologic medicine used to treat psoriatic arthritis. It is also used to treat a number of other inflammatory conditions, including rheumatoid arthritis and plaque psoriasis.

It belongs to a group of medicines called TNF-alpha (TNF-α) inhibitors. Adalimumab is available in several biosimilar brands as well as the original brand, Humira.

How does it work?

Adalimumab blocks the action of a protein called tumour necrosis factor-alpha (TNF-α).

TNF-α is one of the chemical messengers involved in inflammation. Too much TNF-α can contribute to inflammation in the joints and skin in conditions such as psoriatic arthritis and psoriasis.

By blocking TNF-α, adalimumab reduces inflammation. This can help improve symptoms such as joint pain, swelling and stiffness and can also improve psoriasis affecting the skin

Who can get it?

Adalimumab is available on prescription for adults with active psoriatic arthritis. It can be used on its own or in combination with other medicines, including methotrexate. Adalimumab should not be used in people with an active tuberculosis infection or another serious infection, and it should not be used in people with moderate or severe heart failure. It is also contraindicated in people with hypersensitivity to adalimumab or any of the ingredients.

Your doctor will check for infections, including tuberculosis, before treatment and will consider your medical history before prescribing adalimumab.

People with certain neurological conditions, including multiple sclerosis or other demyelinating disorders, require particular caution when treatment with a TNF inhibitor is considered.

How is it used?

Adalimumab is given as an injection under the skin (subcutaneous injection). Many people can learn to administer the injection themselves at home.

For adults with psoriatic arthritis, the usual dose is:

40 mg every other week.

Adalimumab is normally continued for as long as it is controlling the condition and remains appropriate. Your doctor will regularly assess how well the treatment is working.

The dose used for plaque psoriasis is different from the dose used for psoriatic arthritis, so patients should follow the dosing instructions provided for their particular condition.

What are the side effects?

Because adalimumab affects part of the immune system, it can increase the risk of infections.

Common side effects include:

• respiratory tract infections
• headaches
• abdominal pain
• nausea
• diarrhoea
• rash
• itching
• injection-site reactions, such as redness, swelling or pain
• muscle or bone pain
• increased levels of liver enzymes seen in blood tests.

Other side effects can include changes in blood counts and allergic reactions.

Serious infections can occur, including tuberculosis and serious bacterial, fungal or viral infections. Patients should tell their doctor if they develop signs of a serious infection, such as persistent fever, feeling very unwell or a persistent cough.

Rarely, TNF inhibitors have been associated with neurological disorders, heart failure or certain cancers. Your doctor will discuss the risks and benefits of treatment with you.

Pregnancy and breastfeeding

If you are pregnant, planning to become pregnant or breastfeeding, tell your doctor.

Adalimumab can be used during pregnancy when clinically needed. It can also be used during breastfeeding. Your doctor will discuss whether treatment should be continued during pregnancy and whether any changes are needed around the time of delivery.

How do I get adalimumab?

Adalimumab is available on prescription and is generally initiated and monitored by a specialist.

NICE recommends adalimumab and other TNF inhibitors as treatment options for eligible people with active psoriatic arthritis. The choice of biologic depends on factors such as previous treatment, other conditions and whether psoriasis is also present.

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Adalimumab is known commercially as:

Reviewed: August 2026
Version ID: 2/ADA/PAT/08/26

Certolizumab pegol is a biologic medicine used to treat active psoriatic arthritis in adults when previous treatment with disease-modifying antirheumatic drugs (DMARDs) has not worked well enough. It can be used together with methotrexate or on its own when methotrexate is not appropriate or is not tolerated.

It belongs to a group of medicines called TNF-alpha (TNF-α) inhibitors.

How does it work?

Certolizumab pegol blocks the action of a protein called tumour necrosis factor-alpha (TNF-α).

TNF-α is a chemical messenger involved in inflammation. Excessive TNF-α activity contributes to inflammation in conditions such as psoriatic arthritis and psoriasis.

By blocking TNF-α, certolizumab pegol reduces inflammation. This can help reduce joint pain, swelling and stiffness and improve physical function and quality of life.

Who can get it?

Certolizumab pegol is available on prescription for adults with active psoriatic arthritis.

It is not licensed for the treatment of psoriatic arthritis in children.

The NHS use of certolizumab pegol is subject to clinical criteria and specialist assessment. NICE recommends certolizumab pegol as an option for eligible adults with active psoriatic arthritis.

How is it used?

Certolizumab pegol is given as an injection under the skin (subcutaneous injection).

For adults with psoriatic arthritis, the recommended starting treatment is:

• 400 mg (two 200 mg injections) at weeks 0, 2 and 4.
• This is followed by 200 mg every 2 weeks.

Alternatively, after the starting doses, 400 mg every 4 weeks can be considered as a maintenance treatment.

Your doctor will decide which dosing schedule is most appropriate for you. Treatment is normally started and monitored by a specialist.

What are the precautions and side effects?

Because certolizumab pegol affects part of the immune system, it can increase the risk of infections.

Before treatment, you will normally be assessed for tuberculosis (TB) and other infections. People with active TB or another serious infection should not normally start treatment until the infection has been treated.

Tell your doctor if you develop symptoms of an infection during treatment, such as persistent fever, cough or feeling unusually unwell. Treatment may need to be temporarily stopped if you develop a serious infection.

Your doctor may also check for hepatitis B before treatment where appropriate, as TNF inhibitors can cause hepatitis B to reactivate in people who have previously been infected.

Certolizumab pegol should not normally be used in people with moderate or severe heart failure. Tell your doctor if you have heart failure or develop new or worsening symptoms such as increasing breathlessness or swelling of the legs.

Other conditions may require particular caution, including certain neurological disorders, blood disorders, liver problems and a history of cancer. Your doctor will assess your individual risks before treatment.

Possible side effects include:

• infections, including respiratory infections
• headache
• nausea
• fever
• rash and other skin reactions
• itching
• injection-site reactions, such as pain, redness or swelling
• high blood pressure
• weakness or tiredness
• changes in blood cell counts
• changes in liver blood tests
• sensory disturbances, such as tingling or numbness.

Serious allergic reactions can occur but are uncommon. Seek medical attention if you develop swelling of the face, lips, tongue or throat, difficulty breathing or severe dizziness.

Rarely, TNF inhibitors can cause lupus-like reactions, serious infections, blood disorders or neurological problems. Tell your doctor about any new or unexplained symptoms.

Pregnancy and breastfeeding

Certolizumab pegol has an important advantage compared with some other biologic medicines because very little of the medicine crosses the placenta.

It can be used during pregnancy when clinically necessary, and it can also be used while breastfeeding. Your doctor will discuss whether treatment should be continued during pregnancy.

If certolizumab pegol is given during pregnancy, particularly later in pregnancy, tell the baby's healthcare professionals because this may affect the timing of certain live vaccines for the baby.

How do I get certolizumab pegol?

Certolizumab pegol is available on prescription and is normally started and monitored by a specialist.

NICE recommends certolizumab pegol as an option for eligible adults with active psoriatic arthritis when other treatments have not worked adequately or cannot be tolerated.

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Certolizumab pegol is known commercially as Cimzia® and is marketed in the UK by UCB Pharma Ltd.

Reviewed: August 2026
Version ID: 2/CER/PAT/08/26

Etanercept is a biologic medicine used to treat psoriatic arthritis and some other inflammatory conditions. It belongs to a group of medicines called tumour necrosis factor (TNF) inhibitors.

For adults with active and progressive psoriatic arthritis, etanercept may be considered when previous treatment with disease-modifying antirheumatic drugs (DMARDs) has not worked well enough. NICE recommends TNF inhibitors such as etanercept for people who have active peripheral arthritis and have not responded adequately to at least two standard DMARDs.

How does it work?

Etanercept blocks the action of a protein called tumour necrosis factor-alpha (TNF-α). TNF-α is one of the chemical messengers involved in inflammation.

By blocking TNF-α, etanercept reduces inflammation. This can help improve the pain, swelling and stiffness associated with psoriatic arthritis and can help reduce the progression of joint damage.

Who can get it?

Etanercept is available on prescription and treatment should be started and supervised by a specialist experienced in treating inflammatory diseases.

For adults with psoriatic arthritis, it is used when previous DMARD treatment has not worked adequately.

Etanercept can also be prescribed for some children and young people with inflammatory conditions, including juvenile idiopathic arthritis, psoriatic arthritis and severe plaque psoriasis, depending on their age and circumstances.

How is it used?

Etanercept is given as an injection under the skin (subcutaneous injection). Some people can be taught to inject themselves at home.

Psoriatic arthritis

The recommended dose is:

• 25 mg twice a week, or
• 50 mg once a week.

Treatment should be reviewed if there is no adequate response after about 12 weeks. NICE recommends discontinuing treatment if an adequate response to PsA treatment criteria has not been achieved at 12 weeks.

Plaque psoriasis
For adults, the recommended dose is 25 mg twice a week or 50 mg once a week. In some circumstances, 50 mg twice a week can be used for up to 12 weeks before reducing the dose. Treatment should normally be stopped if there is no response after 12 weeks.

Like all medicines that affect the immune system, etanercept can increase the risk of infections.

Common side effects can include:

• infections, including upper respiratory tract infections
• headache
• itching or rash
• injection-site reactions such as redness, itching, pain or swelling
• fever
• nausea
• dizziness
• cough or other respiratory symptoms.

More serious infections can occasionally occur. Before and during treatment, patients may need monitoring for infections such as tuberculosis and hepatitis B.

Rarely, serious allergic reactions, blood disorders, demyelinating disorders, heart failure or certain cancers can occur. Patients should seek medical advice if they develop symptoms of a serious infection or other concerning symptoms.

How do I get etanercept?

Etanercept is available on prescription and is normally initiated and supervised by a specialist.

Etanercept is available in the UK under several brand names, including:

Reviewed: August 2026
Version ID: 2/ETA/PAT/08/26

Golimumab is a biologic medicine used to treat active and progressive psoriatic arthritis in adults when previous treatment with DMARDs has not worked well enough. It belongs to a group of medicines called TNF inhibitors (TNF blockers). It can be used on its own or together with methotrexate.

How does it work?

Golimumab blocks the action of a protein called tumour necrosis factor-alpha (TNF-α). TNF-α is one of the chemical messengers involved in inflammation.

By blocking TNF-α, golimumab reduces inflammation. This can help reduce the pain, swelling and stiffness associated with psoriatic arthritis and can help reduce progression of joint damage.

Who can get it?

Golimumab is available on prescription and treatment should be started and supervised by a specialist experienced in treating inflammatory diseases.

For psoriatic arthritis, it is used in adults with active and progressive disease when previous DMARD treatment has not worked well enough. NICE recommends golimumab as an option for active and progressive psoriatic arthritis when the relevant criteria for TNF-inhibitor treatment are met.

How is it used?

Golimumab is given as an injection under the skin (subcutaneous injection). After appropriate training, some people can give themselves the injection at home.

For psoriatic arthritis, the usual dose is:

50 mg once a month, on the same date each month.

If you weigh more than 100 kg and have not had an adequate response after three or four doses, your doctor may consider increasing the dose to 100 mg once a month. The increased dose is associated with a higher risk of some serious adverse reactions.

Treatment should be reviewed if there is no evidence of benefit after approximately 12–14 weeks (3–4 doses).

What are the side effects?

Like other medicines that block TNF, golimumab can increase the risk of infections.

Very common side effects may include:

• upper respiratory tract infections, such as sore throat, runny nose and hoarseness.

Common side effects may include:

• bacterial infections
• viral infections, including influenza and cold sores
• superficial fungal infections
• bronchitis
• sinusitis
• anaemia
• dizziness
• headache
• high blood pressure
• abnormal liver-function blood tests
• depression
• difficulty sleeping
• stomach pain or indigestion
• constipation
• rash and itching
• hair loss
• weakness
• numbness or tingling
• injection-site reactions, such as redness, itching, pain, bruising or swelling.

More serious but less common effects include serious infections, tuberculosis, pneumonia, hepatitis B reactivation, serious allergic reactions, blood disorders, heart failure, demyelinating disorders and certain cancers. Patients should seek medical advice promptly if they develop symptoms of a serious infection or other concerning symptoms.

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Golimumab is available on prescription and is known commercially as Simponi. It is manufactured in the UK by Janssen-Cilag Ltd (a Johnson & Johnson company).

Reviewed: August 2026
Version ID: 2/GOL/PAT/08/26

Infliximab is a biologic medication for the treatment of psoriatic arthritis in adult patients when the response to DMARD therapy has been inadequate. This biologic medication is a chimeric human murine IgG1 monoclonal antibody.

How does it work?

Infliximab blocks tumour necrosis factor-alpha (TNF-α), a chemical "messenger" in the immune system that signals other cells to cause inflammation. There is too much TNF-α in the skin of people with psoriasis and the joints of people with certain types of arthritis, such as psoriatic arthritis.

Who can get it?

Infliximab is prescribed (in combination with methotrexate) for adult patients with active and progressive psoriatic arthritis.

How is it used?

5 mg/kg given as an intravenous infusion over a 2-hour period followed by additional 5 mg/kg infusion doses at 2 and 6 weeks after the first infusion, then every 8 weeks thereafter.

What are the side effects?

In studies of rheumatoid arthritis and Crohn's disease patients, the most common side effects reported were:

• infusion reactions (fever, chills, rash)
• respiratory infections
• headache,
• vertigo/dizziness
• stomach pain
• itching
• viral infections
• fatigue
• flushing
• fever
• nausea
• diarrhoea
• dyspepsia
   

These side effects are generally mild and did not cause most patients to stop taking Infliximab. These events happened most often after the first Infliximab infusion and may decrease after additional infusions.

How do I get infliximab?

Infliximab is available by prescription, primarily from rheumatologists and gastroenterologists. Some dermatologists are prescribing it for psoriasis.

Available Guidance

National Institute for Health and Care Excellence (NICE) guidance

Scottish Medicine Consortium guidance

All Wales Medicines Strategy Group

For Northern Ireland, the Department of Health, Social Services and Public Safety (DHSSPS) provide reviews and advice.

Read reviews or write your own

If you would like to read other people’s experience of this treatment, or have any comments to share, good or bad, you might like to go to iWantGreatCare for Infliximab, iWantGreatCare for Remicade,   iWantGreatCare for Flixabi, iWantGreatCare for Inflectra and iWantGreatCare for Resima.

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Infliximab is known commercially as:

Ixekizumab is a biological therapy which is used for treating psoriatic arthritis.

How does it work?

Ixekizumab works by neutralising the activity of a protein called IL-17A. It can help to reduce the signs and symptoms of psoriatic arthritis and can help to improve physical function (ability to do normal daily activities), and slowing down the damage to the joints

Who can get it?

It is for use in adults with psoriatic arthritis who do not respond well enough or are intolerant to other medicines.

How is it used?

Ixekizumab is given by injection under the skin (subcutaneous injection).

The first dose is 160 mg (2 syringes with 80 mg each) This may be given by a doctor or nurse in a hospital setting.  After the first dose it will then be an 80 mg dose (1 syringe) every 4 weeks (self-injected).

What are the side effects?

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Serious side effects

Possible serious infection (may affect up to 1 in 100 people) - the signs may include:

• fever, flu-like symptoms, night sweats
  •   feeling tired or short of breath, cough which will not go away
  •   warm, red and painful skin, or a painful skin rash with blisters

Serious allergic reaction - the signs may include:

• difficulty breathing or swallowing
• swelling of the face, lips, tongue or throat
• severe itching of the skin, with a red rash or raised bumps

Other side effects that have been reported

Very common (may affect more than 1 in 10 people):

• upper respiratory tract infections with symptoms such as sore throat and stuffy nose (nasopharyngitis).
• injection site reactions (e.g. red skin, pain).

Common (may affect up to 1 in 10 people):

• fungal infections such as athlete’s foot.
• pain in the back of the throat.
• cold sores of mouth, skin and mucous membranes (herpes simplex, mucocutaneous)

Uncommon (may affect up to 1 in 100 people):

• oral thrush (oral candidiasis).
• influenza.
• runny nose.
• bacterial skin infection.
• hives.
• discharge from the eye with itching, redness and swelling (conjunctivitis).
• signs of low levels of white blood cells, such as fever, sore throat or mouth ulcers due to infections (neutropenia).
• low blood platelet count (thrombocytopenia).
• eczema
• rash
• rapid swelling of the tissues of the neck, face, mouth or throat (angioedema)
• abdominal cramps and pain, diarrhoea, weight loss or blood in the stool (signs of bowel problems)

How do I get Ixekizumab?

Ixekizumab is only available on prescription.

Available Guidance

National Institute for Health and Care Excellence (NICE) guidance
Scottish Medicine Consortium guidance
All Wales Medicines Strategy Group
For Northern Ireland, the Department of Health, Social Services and Public Safety (DHSSPS) provide reviews and advice

Read reviews or write your own

If you would like to read other people’s experience of this treatment, or have any comments to share, good or bad, you might like to go to iWantGreatCare for Ixekizumab or iWantGreatCare for Taltz.

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Ixekizumab is known commercially as Taltz and is marketed in the UK by Eli Lilly.

Secukinumab is a drug used for the treatment of psoriatic arthritis.  It belongs to the group of drugs known as biologics.

How does it work?

Secukinumab  is a monoclonal antibody that selectively binds to and neutralises interleukin-17A (IL-17A).  This inhibits the release of proinflammatory cytokines, chemokines and mediators of tissue damage and reduces IL-17A-mediated contributions to autoimmune and inflammatory diseases. It helps reduce the signs and symptoms of active psoriatic arthritis, improve physical function and slow down the damage to the cartilage and bone of the joints involved in the disease.

Who can get it?

Secukinumab is only available on prescription and is only suitable for adults with active psoriatic arthritis who do not respond to other medicines. 

Do not use if you are allergic to any of the active ingredients in secukinumab or if you have an active infection which your doctor thinks is important.

How is it used?

Secukinumab is given as an injection. You and your health care provider should decide if you should inject secukinumab yourself of whether it should be done in a hospital setting. It is important not to try to inject yourself until you have been trained by your doctor, nurse or pharmacist. A caregiver may also give you your injection after proper training.

The recommended dose is 150 mg by subcutaneous injection. After the first dose you will receive further weekly injections at weeks 1, 2, 3 and 4 followed by monthly injections. Based on your response, your doctor may increase your dose to 300 mg.

What are the side effects?

• Serious side effects
• Stop using secukinumab and tell your doctor or seek medical help immediately if you get any of the following side effects.
• fever, flu-like symptoms, night sweats
• feeling tired or short of breath, cough which will not go away
• warm, red and painful skin, or a painful skin rash with blisters
• burning sensation when passing urine.

• Serious allergic reaction - the signs may include: 
• difficulty breathing or swallowing
• low blood pressure, which can cause dizziness or light-headedness
• swelling of the face, lips, tongue or throat
• severe itching of the skin, with a red rash or raised bumps.

• Some side effects are very common (may affect more than 1 in 10 people): 
• upper respiratory tract infections with symptoms such as sore throat and stuffy nose (nasopharyngitis, rhinitis)
  
  

• Some side effects are common (may affect up to 1 in 10 people):

• cold sores (oral herpes)
• diarrhoea
• runny nose (rhinorrhoea)
• athlete’s foot (tinea pedis)
• headache
• nausea
• fatigue

• Some side effects are uncommon (may affect up to 1 in 100 people): 
• oral thrush (oral candidiasis)
• signs of low levels of white blood cells, such as fever, sore throat or mouth ulcers due to infections (neutropenia)
• infection of the external ear (otitis externa)
• discharge from the eye with itching, redness and swelling (conjunctivitis)
• itchy rash (urticaria)
• lower respiratory tract infections
• abdominal cramps and pain, diarrhoea, weight loss or blood in the stool (signs of bowel problems)
• Rare (may affect up to 1 in 1,000 people):
• severe allergic reaction with shock (anaphylactic reaction)
• redness and shedding of skin over a larger area of the body, which may be itchy or painful (exfoliative dermatitis)

Further guidance

National Institute for Health and Care Excellence (NICE) guidance
Scottish Medicine Consortium guidance
All Wales Medicines Strategy Group
For Northern Ireland, the Department of Health, Social Services and Public Safety (DHSSPS) provide reviews and advice

Read reviews or write your own

If you would like to read other people’s experience of this treatment, or have any comments to share, good or bad, you might like to go to iWantGreatCare for Secukinumab or iWantGreatCare for Cosentyx.

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Secukinumab is known commercially as Cosentyx and is marketed by Novartis.

Ustekinumab is a biological therapy used either alone or with methotrexate for the treatment of active psoriatic arthritis in adult patients who did not respond to other disease modifying drugs. It belongs to the group of treatments known as immunosuppresants (medicines that inhibit your immune system).

How does it work?

Ustekinumab blocks tumour necrosis factor-alpha (TNF-α), a chemical "messenger" in the immune system that signals other cells to cause inflammation. There is too much TNF-α in the skin of people with psoriasis and the joints of people with certain types of arthritis, such as psoriatic arthritis.

Who can get it?

Available to adults who have not responded to other disease modifying drugs.

How is it used?

For adults over 18 years of age with a body weight of less than 100kg, initially 45mg by subcutaneous injection.  If body weight is more than 100kg initially 90mg by subcutaneous injection.  Repeat the dose after 4 weeks, then every 12 weeks.  Consider discontinuation if no response after 28 weeks. 

What are the side effects?

Common side effects (may affect up to 1 in 10 people):

• Diarrhoea
• Nausea
• Feeling tired
• Feeling dizzy
• Headache
• Itching (‘pruritus’)
• Back, muscle or joint pain
• Sore throat
• Tooth infections
• Redness and pain where the injection is given.

Uncommon side effects (may affect up to 1 in 100 people):

• Depression
• Blocked or stuffy nose
• Bleeding, bruising, hardness, swelling and itching where the injection is given
• Drooping eyelid and sagging muscles on one side of the face (‘facial palsy’ or ‘Bell’s palsy’), which is usually temporary
• A change in psoriasis with redness and new tiny, yellow or white skin blisters, sometimes accompanied by fever (pustular psoriasis).

In patients with psoriasis, exfoliative dermatitis has been reported following ustekinumab treatment. Patients with plaque psoriasis may develop erythrodermic psoriasis, with symptoms that may be clinically indistinguishable from exfoliative dermatitis, as part of the natural course of their disease. As part of the monitoring of the patient’s psoriasis, physicians should be alert for symptoms of erythrodermic psoriasis or exfoliative dermatitis. If these symptoms occur, appropriate therapy should be instituted. Ustekinumab should be discontinued if a drug reaction is suspected.

How do I get ustekinumab?

Ustekinumab is available by prescription, primarily from rheumatologists. It is also prescribed by dermatologists for psoriasis.

Available Guidance

National Institute for Health and Care Excellence (NICE) guidance

Scottish Medicine Consortium guidance for ustekinumab

All Wales Medicines Strategy Group advice on ustekinumab

For Northern Ireland, the Department of Health, Social Services and Public Safety (DHSSPS) provide reviews and advice.

Read reviews or write your own

If you would like to read other people’s experience of this treatment, or have any comments to share, good or bad, you might like to go to iWantGreatCare for Ustekinumab or iWantGreatCare for Stelara.

Marketed by

Ustekinumab is known commercially as Stelara and is marketed in the UK by Janssen Ltd