II. Indications
- Severe Plaque Psoriasis
- Psoriatic Arthritis
- Moderate to Severe Crohn's Disease
III. Contraindications
- Serious infection
- High risk of malignancy
IV. Mechanism
- Humanized Monoclonal Antibody against the Interleukins IL-12 and IL-23 (at P40 Protein subunit)
- Immunomodulating activity, inhibiting CD4 positive T cells from differentiating into Th1 and Th17 cells
- Results in specifically reduced Th1 and Th17 specific immune function and associated Cytokine release
- May prevent Graft Versus Host Disease (GVHD)
V. Precautions
- Prepare for Monoclonal Antibody use with infection screening (e.g. Tuberculosis) and Immunizations
VI. Dosing
- Severe Plaque Psoriasis or Psoriatic Arthritis (adults or age >12 years)
- Weight <100 kg
- Induction: Inject 45 mg SQ at 0 and 4 weeks
- Maintenance: 45 mg SQ every 12 weeks
- Weight >100 kg
- Induction: Inject 90 mg SQ at 0 and 4 weeks
- Maintenance: 90 mg SQ every 12 weeks
- Weight <100 kg
- Moderate to Severe Crohns Disease
- Induction
- Maintenance
- Inject 90 mg SQ every 8 weeks (starting 8 weeks after IV ibfusion)
VII. Safety
- Pregnancy Category B
- Unknown safety in Lactation
VIII. Adverse Effects
- Serious infection
- Hypersensitivity
- Malignancy exacerbation (e.g. Skin Cancer)
- Reversible Posterior Leukoencephalopathy
IX. Resources
X. References
- (2023) Biologics for Crohn's Disease, Presc Lett, #390826
- (2023) Drugs for Inflammatory Bowel Disease, Med Lett Drug Ther 65: 105-12
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