Ustekinumab

Ustekinumab（商业名称Stelara）是一种生物疗法。它通过与细胞上的两个特定蛋白结合结合而起作用，这些蛋白质又干扰了一组称为T细胞的白细胞的功能。这修改了免疫系统的活动，以减少引起症状的炎症银屑病关节炎.

Ustekinumab can be prescribed by a consultant or other clinical rheumatology specialist for adults with psoriatic arthritis. It’s a long-term treatment, so it may be up to six months before you start to notice the benefits. It can be used alone or with甲氨蝶呤.

Ustekinumab won’t be started if:

• your arthritis isn’t active
• you’re pregnant or breastfeeding
• 您尚未尝试首先尝试适合您的病情的其他治疗方法。

Your doctor may decide not to prescribe ustekinumab if:

• you have, or have recently had, an infection
• you’ve had phototherapy treatment for psoriasis
• you’ve had injections to treat allergies
• you’ve had cancer.

You’ll have blood tests before treatment starts to assess your disease and whether the drug is suitable for you. Your doctor will also check if you’ve previously been exposed to tuberculosis (TB), and you may need a course of treatment for latent (asymptomatic) TB before starting ustekinumab.

You’ll be monitored regularly while taking ustekinumab, and if you’re taking other drugs alongside (such as methotrexate), you’ll also need to continue your blood tests for these.

使用预填充的注射器避免了牛皮癣区域，将乌斯凯尼亚单抗作为皮肤下的注射（皮下注射）。在第一次剂量之后，您将在四个星期后再过一次，然后从那时开始每12周。规定的剂量将取决于您的体重。首先，护士通常会给您注射。但是您，您的伴侣或其他家庭成员也可以向他们展示如何给他们。

If you have a latex allergy you should mention this to your doctor as the needle cover on the pre-filled syringe may contain latex and could cause a reaction.

如果您错过了剂量，请询问风湿病团队，以获取有关何时下一次剂量的建议。因为这是一种长期治疗方法，所以继续服用乌斯凯尼亚姆（除非您具有严重的副作用）很重要：

• even if it doesn’t seem to be working at first
• 即使您的症状得到改善（以帮助控制疾病）。

Some side-effects can happen around the time of the injection. The most common are dizziness, sore throat, joint pain, headaches, feeling sick (nausea), and soreness around the injection site. These aren’t usually serious.

由于乌斯甲基单抗会影响您的免疫系统，因此您可能更有可能接收感染。如果您有任何感染症状（包括发烧，感到疲倦或呼吸不足，持续咳嗽，在排尿或腹泻时燃烧），或者如果您有任何疑问，请与您的交谈风湿病团队immediately. They may advise you to delay your next dose until you’re better.

Some people may have an allergic reaction with sudden swelling, a rash or breathlessness. This is very rare, but if you do develop these symptoms, or any other severe symptoms, during or soon after a dose of ustekinumab, you should seek medical advice immediately.

降低感染的风险

• 尽量避免与患有严重主动感染的人密切接触。
• For advice on avoiding infection from food, visit:https://www.nhs.uk/conditions/food-poisoning/pages/prevention.aspx

You may be taking甲氨蝶呤as well as ustekinumab. However, some medicines may interact with ustekinumab. Check with your doctor before starting any new medicines, and remember to mention you’re on ustekinumab if you’re treated by anyone other than your usual风湿病团队.

• You can carry on takingnon-steroidal anti-inflammatory drugs (NSAIDs)或者止痛药，如果需要，除非您的医生另有建议。
• 不要首先与风湿病团队讨论非处方药或草药。

It’s recommended that you carry a biological therapy alert card, so anyone treating you will know that you’re on ustekinumab – ask your rheumatology team for a card.

Vaccinations

It’s best to speak to your healthcare team about any vaccinations you might need before starting treatment with ustekinumab. Generally, you should avoid live vaccines while you’re on ustekinumab – these include measles, mumps, rubella, yellow fever and shingles. You should also avoid having tuberculosis (BCG) vaccination for a year after stopping treatment with ustekinumab.

流感疫苗很好，通常建议使用。

Having an operation

If you’re thinking about having surgery, talk this over with your rheumatology team. For most operations you’ll be advised to stop ustekinumab beforehand. You can restart when your wound is healed and there are no signs of infection.

Ustekinumab和酒精之间没有已知的相互作用。但是，如果您也要服用甲氨蝶呤, this can interact with alcohol and affect your liver so you should keep well within the recommended limits of no more than 14 units of alcohol per week for adults – unless your doctor advises a lower limit.

If you're thinking of trying for a baby, talk to your rheumatology team in advance so that you can plan what to do with your medication.

The latest guidelines say that women can take ustekinumab while trying to become pregnant. But it's recommended that women stop taking this drug if they become pregnant.

服用Ustekinumab时，您应该可以接受母乳喂养，但是研究受到限制，因此您应该与医生讨论这一点。