Ustekinumab STELARA®

WHAT CHECKS WILL I NEED BEFORE I START IT?

Pre-treatment screening is essential to check your suitability for treatment with ustekinumab. Make sure our IBD team treating you knows the following:

• If you have any history of tuberculosis (TB) or any recent exposure to people with TB. You should not be given ustekinumab if you have active TB, and if you have underlying inactive TB, this will need to be treated before starting ustekinumab. Most doctors now use a blood test to check for underlying or inactive TB, but you may be given a chest X-ray as well
• If you have been in contact with people who have chicken pox, shingles, measles or pneumococcal disease (an infection which can lead to pneumonia, meningitis and sepsis)
• If you are not already immune to chicken pox or measles, you may need vaccinations against these before starting treatment. You may also be advised to have a vaccination against pneumococcal disease
• If you have heart problems, as ustekinumab might make your condition worse, and your heart will need to be monitored closely before, during and after treatment
• If you have a history of cancer. Ustekinumab affects how the immune system works and you may have a slightly increased risk of developing some types of cancer. However, you may also be at risk even if you do not have a history of cancer
• If you smoke, or have COPD (Chronic Obstructive Pulmonary Disease) as taking ustekinumab may increase your risk of lung cancer
• If you have ever had HIV, hepatitis B or C (viral liver infections), are a carrier of hepatitis B or C or have recently been in close contact with someone who has hepatitis B or C. You will usually have a blood test to check for these viruses before starting ustekinumab, and also be monitored for six months after stopping ustekinumab
• If you have ever lived in a region where certain fungal diseases (such as histoplasmosis, blastomycosis or coccidioidomycosis) are common (eg parts of USA, South America and Africa)
• If you have a fistula or an abscess. Ustekinumab can help to close fistulas but any abscess must be drained before treatment with ustekinumab
• If you have ever had a disease that affects the nervous system, such as multiple sclerosis, Guillain-Barre syndrome, or have experienced any numbness, tingling, fits, or visual disturbances
• If you have diabetes or an immune system problem
• If you have ever received phototherapy for psoriasis. This is because it can increase your risk of developing skin cancer
• If you have a history of repeated infections or currently have an infection or have symptoms such as feeling feverish or generally unwell. If you have an infection your ustekinumab treatment may need to be postponed
• If you are pregnant, planning to get pregnant, or are breastfeeding
• About any medications you are taking and any recent vaccinations. Also, if you have ever taken any other biological drug
• If you are going to have any operations or dental treatments

 

Just before each infusion your blood pressure, pulse rate and temperature will be checked. You may also be asked to give urine or blood samples

 

References