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ISSN 0210-5187 (Electronic)

2012, Number 2

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Med Cutan Iber Lat Am 2012; 40 (2)

Ustekinumab within the hospital terapeutic

González-Guerra E

Language: Spanish
References: 29
Page: 49-57
PDF size: 93.23 Kb.


ABSTRACT

The incorporation of drugs to clinical practice has numerous economic, clinical and administration consequences. Thus, before starting any treatment it is necessary a preliminary evaluation of the drug according to evidence-based medicine criteria. The present article discusses the main characteristics of ustekinumab, a biologic drug prescribed for the treatment of moderate to severe plaque psoriasis. Although there is no justification for this strategy a number of hospitals use this agent as second-line treatment in anti-TNF monoclonal antibody unresponsive patients. The responsibility to include ustekinumab in the hospital pharmacy belongs to the Pharmacy and Therapeutics Committee. However, the person who knows best the drug is the referring clinician and in turn he is the responsible of making the relevant data available to the committee.
Ustekinumab is a monoclonal antibody that specifically targets the cytokines interleukin 12 (IL-12) and interleukin 23 (IL-23). The main advantages of ustekinumab are its rapid onset of action and short-term clinical effectiveness. The effect of ustekinumab can be found three years after the end of treatment and the rates of adverse effects of ustekinumab are similar to placebo. Compared to other prescribed medications to treat psoriasis, as anti-TNF, it is not contraindicated in patients with moderate or severe congestive heart failure (NYHA III/IV) neither in demyelinating diseases. The main advantage of ustekinumab is its easy administration and dosage in comparison with other treatments. For all this reasons, ustekinumab is a useful therapeutic agent for the treatment of patients with chronic plaque psoriasis. Due to ethical and equity reasons, all biologic agents that have been approved for the treatment of psoriasis must be available for all patients who are candidates for the treatment, without limitations that may involve inequality for the patient. This is the primary objective of this paper.


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