Ustekinumab binds IL-12 and IL-23, while anti TNF- alfa drugs bind TNF-alfa. Does TNF exerts more effect on the immune system than IL-12 and IL-23 or is it just less studied and understood?
There is a nice articleat the following link that may answer your question. http://www.skintherapyletter.com/2008/13.8/1.html
The article recommended was excellent review, thank you.
What may be helpful to you now is that Janssen currently has the 5 year post-marketing data available for Stelara. Based on this, It is comforting that no increase in adverse events has been seen since widespread use in the psoriatic population. There remains a concern about infection with both classes of biologics but there is no concern about demyelinating disease or CHF with Stelara.
From a treating physicians point of view the most compelling reason to use Stelara is the clinical efficacy which is impressive in my hands, especially in patients who have already failed theTNF-alpha class.
Hope this helps.
Luciann, I too have seen this be the case with my patients and am comfortable using Stelera
As a future patient who will use Ustekinumab, I do hope both doctors are right about the impressive clinical efficacy of this treatment: indeed, in my case no TNF alpha blocker worked to stop my psoriatic arthritis.