Source

• Fully human

Mechanism of Action

• Monoclonal IgG1 that targets p40 subunit of IL12/23, inhibiting T cell differentiation and cytokine production 
• Blocks Th1 and Th17 differentiation

Dose

• Subcutaneous
• Weight based:
  • Less than 100 kg: 45 mg loading dose and at 1 month then 45 mg every 3 months
  • More than 100 kg: 90 mg loading dose and at 1 month then 90 mg every 3 months
  • Children 12 years old and older: less than 60 kg: 0.75 mg/kg; if more than 60 kg follow adult dosing

Indications

• FDA dermatology: Psoriasis and Psoriatic arthritis
• Off label: Hidradenitis suppurativa, Pyoderma gangrenosum, Lupus erythromatosus

Contraindications

• Hypersensitivity reaction
• Active infection
• Concomitant live vaccines
• Malignancy

Side Effects

• Injection site reaction
• Pharyngitis
• Diarrhea
• Fatigue
• Headache
• Pustular and erythrodermic psoriasis
• Infections: mucocutaneous candidiasis, disseminated mycobacterial infection, and salmonella
• Leukoencephalopathy

Pregnancy Category

• Pregnancy Category B

Notes

• No neurological complications have been reported, so can be considered in demyelinating diseases
• Patients with Il12/23 deficiency have an increased risk of mycobacterial infection and salmonellosis
• BCG vaccine should not be given within 1 year prior to treatment
• Approved in Europe for 12 years and older
• More efficacy for psoriasis than for psoriatic arthritis
• 4% develop antibodies against the drug