Psoriatic Arthritis treatments: Biologics

Risankizumab is a biological medicine used to treat adults with active psoriatic arthritis. It may be used when previous treatment with one or more disease-modifying antirheumatic drugs (DMARDs) has not worked well enough or has not been tolerated.

Risankizumab can be used on its own or in combination with other medicines used to treat psoriatic arthritis.

How does it work?

Risankizumab is a biological medicine that specifically blocks a protein called interleukin-23 (IL-23). IL-23 plays an important role in causing inflammation in psoriasis and psoriatic arthritis.

By blocking IL-23, risankizumab reduces inflammation and can help improve symptoms such as joint pain, stiffness and swelling. It can also improve psoriasis affecting the skin and nails and may help slow the progression of joint damage.

Who can get it?

Risankizumab is available on prescription for adults with active psoriatic arthritis.

Your specialist will decide whether risankizumab is suitable for you, taking into account your previous treatments and how active your condition is.

Before treatment begins, you will usually be checked for infections, including tuberculosis (TB). Risankizumab should not normally be given to people with a clinically important active infection.

How is it used?

Risankizumab is given as an injection under the skin (subcutaneous injection).

For psoriatic arthritis, the usual dose is:

• 150 mg at week 0
• 150 mg at week 4
• followed by 150 mg every 12 weeks.

Each 150 mg dose is given as two 75 mg injections.

Your healthcare professional may teach you how to give the injections yourself, or they may be administered by a healthcare professional.

What are the side effects?

Like all medicines, risankizumab can cause side effects, although not everyone experiences them.

Very common: may affect more than 1 in 10 people

• Upper respiratory tract infections, such as a sore throat or blocked nose.

Common: may affect up to 1 in 10 people

• Tiredness
• Fungal skin infections
• Injection-site reactions, such as redness, swelling or pain
• Itching

• Headache.

Uncommon: may affect up to 1 in 100 people

• Small raised red bumps on the skin.

Because risankizumab affects part of the immune system, it can make some infections more likely. Tell your doctor if you develop signs of an infection, particularly a persistent fever, chills, night sweats, a persistent cough, shortness of breath, or painful, warm or reddened skin.

You should also tell your doctor if you have an infection before having an injection.

How do I get risankizumab?

Risankizumab is available on prescription only and is normally prescribed and monitored by a specialist.

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Risankizumab is known commercially as Skyrizi® and is marketed in the UK by AbbVie Ltd.

Reviewed: August 2026
Version ID: 2/RIS/PAT/08/26

Bimekizumab is a biologic medicine used to treat adults with active psoriatic arthritis when other disease-modifying antirheumatic drugs (DMARDs) have not worked well enough or cannot be tolerated. It can be used on its own or together with methotrexate. NICE recommends bimekizumab for certain adults with active psoriatic arthritis who have not responded adequately to previous DMARD treatment.

Bimekizumab is also used to treat moderate to severe plaque psoriasis and some other inflammatory conditions.

How does it work?

Bimekizumab is a biologic medicine called an interleukin-17 (IL-17) inhibitor. It blocks two inflammatory proteins, IL-17A and IL-17F, which play an important role in the inflammation associated with psoriatic arthritis and psoriasis.

By reducing the activity of these proteins, bimekizumab reduces inflammation. This can help improve joint pain, stiffness and swelling, as well as psoriasis affecting the skin and nails. It can also improve physical functioning and quality of life.

Who can get it?

Bimekizumab is available on prescription for adults with active psoriatic arthritis.

For NHS treatment, NICE recommends it for adults whose psoriatic arthritis has not responded well enough to DMARDs or who cannot tolerate them, and who have had two conventional DMARDs and at least one biological DMARD, or for whom TNF-alpha inhibitors are contraindicated.

It can be used on its own or with methotrexate.

How is it used?

Bimekizumab is given as an injection under the skin (subcutaneous injection).

For psoriatic arthritis, the usual dose is:

• 160 mg once every 4 weeks.

If you have psoriatic arthritis together with moderate to severe plaque psoriasis, the recommended dose is:

• 320 mg at weeks 0, 4, 8, 12 and 16, followed by 320 mg every 8 weeks.
• After week 16, if the joint response is not maintained, your doctor may consider changing the dose to 160 mg every 4 weeks.

Your doctor will assess how well the treatment is working and decide whether you should continue treatment.

What are the side effects?

Like all medicines, bimekizumab can cause side effects, although not everyone gets them.

Very common

• Upper respiratory tract infections, such as a sore throat or blocked nose.

Common

• Oral thrush (candidiasis)
• Fungal skin infections, such as athlete's foot
• Ear infections
• Cold sores (herpes simplex)
• Gastroenteritis
• Inflamed hair follicles (folliculitis)
• Headache
• Rash, dermatitis or eczema
• Acne
• Injection-site reactions, such as redness, swelling or pain
• Feeling tired (fatigue).

Uncommon

• Reduced levels of certain white blood cells (neutropenia)
• Fungal infections affecting the skin or mucous membranes, including the oesophagus
• Conjunctivitis
• Inflammatory bowel disease.

Serious allergic reactions, including anaphylaxis, have been reported with IL-17 inhibitors. Seek urgent medical attention if you develop symptoms of a serious allergic reaction, such as swelling of the face, lips, tongue or throat, difficulty breathing or severe dizziness.

Because bimekizumab affects part of the immune system, your doctor will check for infections and other relevant health problems before and during treatment.

How do I get bimekizumab?

Bimekizumab is available on prescription and is normally started and monitored by a healthcare professional experienced in treating psoriatic arthritis.

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Bimekizumab is known commercially as Bimzelx and is marketed in the UK by UCB Pharma Ltd

Reviewed: August 2026
Version ID: 2/BIM/PAT/08/26

Adalimumab is a biologic medicine used to treat psoriatic arthritis. It is also used to treat a number of other inflammatory conditions, including rheumatoid arthritis and plaque psoriasis.

It belongs to a group of medicines called TNF-alpha (TNF-α) inhibitors. Adalimumab is available in several biosimilar brands as well as the original brand, Humira.

How does it work?

Adalimumab blocks the action of a protein called tumour necrosis factor-alpha (TNF-α).

TNF-α is one of the chemical messengers involved in inflammation. Too much TNF-α can contribute to inflammation in the joints and skin in conditions such as psoriatic arthritis and psoriasis.

By blocking TNF-α, adalimumab reduces inflammation. This can help improve symptoms such as joint pain, swelling and stiffness and can also improve psoriasis affecting the skin

Who can get it?

Adalimumab is available on prescription for adults with active psoriatic arthritis. It can be used on its own or in combination with other medicines, including methotrexate. Adalimumab should not be used in people with an active tuberculosis infection or another serious infection, and it should not be used in people with moderate or severe heart failure. It is also contraindicated in people with hypersensitivity to adalimumab or any of the ingredients.

Your doctor will check for infections, including tuberculosis, before treatment and will consider your medical history before prescribing adalimumab.

People with certain neurological conditions, including multiple sclerosis or other demyelinating disorders, require particular caution when treatment with a TNF inhibitor is considered.

How is it used?

Adalimumab is given as an injection under the skin (subcutaneous injection). Many people can learn to administer the injection themselves at home.

For adults with psoriatic arthritis, the usual dose is:

40 mg every other week.

Adalimumab is normally continued for as long as it is controlling the condition and remains appropriate. Your doctor will regularly assess how well the treatment is working.

The dose used for plaque psoriasis is different from the dose used for psoriatic arthritis, so patients should follow the dosing instructions provided for their particular condition.

What are the side effects?

Because adalimumab affects part of the immune system, it can increase the risk of infections.

Common side effects include:

• respiratory tract infections
• headaches
• abdominal pain
• nausea
• diarrhoea
• rash
• itching
• injection-site reactions, such as redness, swelling or pain
• muscle or bone pain
• increased levels of liver enzymes seen in blood tests.

Other side effects can include changes in blood counts and allergic reactions.

Serious infections can occur, including tuberculosis and serious bacterial, fungal or viral infections. Patients should tell their doctor if they develop signs of a serious infection, such as persistent fever, feeling very unwell or a persistent cough.

Rarely, TNF inhibitors have been associated with neurological disorders, heart failure or certain cancers. Your doctor will discuss the risks and benefits of treatment with you.

Pregnancy and breastfeeding

If you are pregnant, planning to become pregnant or breastfeeding, tell your doctor.

Adalimumab can be used during pregnancy when clinically needed. It can also be used during breastfeeding. Your doctor will discuss whether treatment should be continued during pregnancy and whether any changes are needed around the time of delivery.

How do I get adalimumab?

Adalimumab is available on prescription and is generally initiated and monitored by a specialist.

NICE recommends adalimumab and other TNF inhibitors as treatment options for eligible people with active psoriatic arthritis. The choice of biologic depends on factors such as previous treatment, other conditions and whether psoriasis is also present.

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Adalimumab is known commercially as:

Reviewed: August 2026
Version ID: 2/ADA/PAT/08/26

Certolizumab pegol is a biologic medicine used to treat active psoriatic arthritis in adults when previous treatment with disease-modifying antirheumatic drugs (DMARDs) has not worked well enough. It can be used together with methotrexate or on its own when methotrexate is not appropriate or is not tolerated.

It belongs to a group of medicines called TNF-alpha (TNF-α) inhibitors.

How does it work?

Certolizumab pegol blocks the action of a protein called tumour necrosis factor-alpha (TNF-α).

TNF-α is a chemical messenger involved in inflammation. Excessive TNF-α activity contributes to inflammation in conditions such as psoriatic arthritis and psoriasis.

By blocking TNF-α, certolizumab pegol reduces inflammation. This can help reduce joint pain, swelling and stiffness and improve physical function and quality of life.

Who can get it?

Certolizumab pegol is available on prescription for adults with active psoriatic arthritis.

It is not licensed for the treatment of psoriatic arthritis in children.

The NHS use of certolizumab pegol is subject to clinical criteria and specialist assessment. NICE recommends certolizumab pegol as an option for eligible adults with active psoriatic arthritis.

How is it used?

Certolizumab pegol is given as an injection under the skin (subcutaneous injection).

For adults with psoriatic arthritis, the recommended starting treatment is:

• 400 mg (two 200 mg injections) at weeks 0, 2 and 4.
• This is followed by 200 mg every 2 weeks.

Alternatively, after the starting doses, 400 mg every 4 weeks can be considered as a maintenance treatment.

Your doctor will decide which dosing schedule is most appropriate for you. Treatment is normally started and monitored by a specialist.

What are the precautions and side effects?

Because certolizumab pegol affects part of the immune system, it can increase the risk of infections.

Before treatment, you will normally be assessed for tuberculosis (TB) and other infections. People with active TB or another serious infection should not normally start treatment until the infection has been treated.

Tell your doctor if you develop symptoms of an infection during treatment, such as persistent fever, cough or feeling unusually unwell. Treatment may need to be temporarily stopped if you develop a serious infection.

Your doctor may also check for hepatitis B before treatment where appropriate, as TNF inhibitors can cause hepatitis B to reactivate in people who have previously been infected.

Certolizumab pegol should not normally be used in people with moderate or severe heart failure. Tell your doctor if you have heart failure or develop new or worsening symptoms such as increasing breathlessness or swelling of the legs.

Other conditions may require particular caution, including certain neurological disorders, blood disorders, liver problems and a history of cancer. Your doctor will assess your individual risks before treatment.

Possible side effects include:

• infections, including respiratory infections
• headache
• nausea
• fever
• rash and other skin reactions
• itching
• injection-site reactions, such as pain, redness or swelling
• high blood pressure
• weakness or tiredness
• changes in blood cell counts
• changes in liver blood tests
• sensory disturbances, such as tingling or numbness.

Serious allergic reactions can occur but are uncommon. Seek medical attention if you develop swelling of the face, lips, tongue or throat, difficulty breathing or severe dizziness.

Rarely, TNF inhibitors can cause lupus-like reactions, serious infections, blood disorders or neurological problems. Tell your doctor about any new or unexplained symptoms.

Pregnancy and breastfeeding

Certolizumab pegol has an important advantage compared with some other biologic medicines because very little of the medicine crosses the placenta.

It can be used during pregnancy when clinically necessary, and it can also be used while breastfeeding. Your doctor will discuss whether treatment should be continued during pregnancy.

If certolizumab pegol is given during pregnancy, particularly later in pregnancy, tell the baby's healthcare professionals because this may affect the timing of certain live vaccines for the baby.

How do I get certolizumab pegol?

Certolizumab pegol is available on prescription and is normally started and monitored by a specialist.

NICE recommends certolizumab pegol as an option for eligible adults with active psoriatic arthritis when other treatments have not worked adequately or cannot be tolerated.

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Certolizumab pegol is known commercially as Cimzia® and is marketed in the UK by UCB Pharma Ltd.

Reviewed: August 2026
Version ID: 2/CER/PAT/08/26

Etanercept is a biologic medicine used to treat psoriatic arthritis and some other inflammatory conditions. It belongs to a group of medicines called tumour necrosis factor (TNF) inhibitors.

For adults with active and progressive psoriatic arthritis, etanercept may be considered when previous treatment with disease-modifying antirheumatic drugs (DMARDs) has not worked well enough. NICE recommends TNF inhibitors such as etanercept for people who have active peripheral arthritis and have not responded adequately to at least two standard DMARDs.

How does it work?

Etanercept blocks the action of a protein called tumour necrosis factor-alpha (TNF-α). TNF-α is one of the chemical messengers involved in inflammation.

By blocking TNF-α, etanercept reduces inflammation. This can help improve the pain, swelling and stiffness associated with psoriatic arthritis and can help reduce the progression of joint damage.

Who can get it?

Etanercept is available on prescription and treatment should be started and supervised by a specialist experienced in treating inflammatory diseases.

For adults with psoriatic arthritis, it is used when previous DMARD treatment has not worked adequately.

Etanercept can also be prescribed for some children and young people with inflammatory conditions, including juvenile idiopathic arthritis, psoriatic arthritis and severe plaque psoriasis, depending on their age and circumstances.

How is it used?

Etanercept is given as an injection under the skin (subcutaneous injection). Some people can be taught to inject themselves at home.

Psoriatic arthritis

The recommended dose is:

• 25 mg twice a week, or
• 50 mg once a week.

Treatment should be reviewed if there is no adequate response after about 12 weeks. NICE recommends discontinuing treatment if an adequate response to PsA treatment criteria has not been achieved at 12 weeks.

Plaque psoriasis
For adults, the recommended dose is 25 mg twice a week or 50 mg once a week. In some circumstances, 50 mg twice a week can be used for up to 12 weeks before reducing the dose. Treatment should normally be stopped if there is no response after 12 weeks.

Like all medicines that affect the immune system, etanercept can increase the risk of infections.

Common side effects can include:

• infections, including upper respiratory tract infections
• headache
• itching or rash
• injection-site reactions such as redness, itching, pain or swelling
• fever
• nausea
• dizziness
• cough or other respiratory symptoms.

More serious infections can occasionally occur. Before and during treatment, patients may need monitoring for infections such as tuberculosis and hepatitis B.

Rarely, serious allergic reactions, blood disorders, demyelinating disorders, heart failure or certain cancers can occur. Patients should seek medical advice if they develop symptoms of a serious infection or other concerning symptoms.

How do I get etanercept?

Etanercept is available on prescription and is normally initiated and supervised by a specialist.

Etanercept is available in the UK under several brand names, including:

Reviewed: August 2026
Version ID: 2/ETA/PAT/08/26

Golimumab is a biologic medicine used to treat active and progressive psoriatic arthritis in adults when previous treatment with DMARDs has not worked well enough. It belongs to a group of medicines called TNF inhibitors (TNF blockers). It can be used on its own or together with methotrexate.

How does it work?

Golimumab blocks the action of a protein called tumour necrosis factor-alpha (TNF-α). TNF-α is one of the chemical messengers involved in inflammation.

By blocking TNF-α, golimumab reduces inflammation. This can help reduce the pain, swelling and stiffness associated with psoriatic arthritis and can help reduce progression of joint damage.

Who can get it?

Golimumab is available on prescription and treatment should be started and supervised by a specialist experienced in treating inflammatory diseases.

For psoriatic arthritis, it is used in adults with active and progressive disease when previous DMARD treatment has not worked well enough. NICE recommends golimumab as an option for active and progressive psoriatic arthritis when the relevant criteria for TNF-inhibitor treatment are met.

How is it used?

Golimumab is given as an injection under the skin (subcutaneous injection). After appropriate training, some people can give themselves the injection at home.

For psoriatic arthritis, the usual dose is:

50 mg once a month, on the same date each month.

If you weigh more than 100 kg and have not had an adequate response after three or four doses, your doctor may consider increasing the dose to 100 mg once a month. The increased dose is associated with a higher risk of some serious adverse reactions.

Treatment should be reviewed if there is no evidence of benefit after approximately 12–14 weeks (3–4 doses).

What are the side effects?

Like other medicines that block TNF, golimumab can increase the risk of infections.

Very common side effects may include:

• upper respiratory tract infections, such as sore throat, runny nose and hoarseness.

Common side effects may include:

• bacterial infections
• viral infections, including influenza and cold sores
• superficial fungal infections
• bronchitis
• sinusitis
• anaemia
• dizziness
• headache
• high blood pressure
• abnormal liver-function blood tests
• depression
• difficulty sleeping
• stomach pain or indigestion
• constipation
• rash and itching
• hair loss
• weakness
• numbness or tingling
• injection-site reactions, such as redness, itching, pain, bruising or swelling.

More serious but less common effects include serious infections, tuberculosis, pneumonia, hepatitis B reactivation, serious allergic reactions, blood disorders, heart failure, demyelinating disorders and certain cancers. Patients should seek medical advice promptly if they develop symptoms of a serious infection or other concerning symptoms.

Marketed by

Golimumab is available on prescription and is known commercially as Simponi. It is manufactured in the UK by Janssen-Cilag Ltd (a Johnson & Johnson company).

Reviewed: August 2026
Version ID: 2/GOL/PAT/08/26

Infliximab is a biologic medicine used to treat active and progressive psoriatic arthritis in adults when previous disease-modifying antirheumatic drugs (DMARDs) have not worked well enough. It belongs to a group of medicines called TNF inhibitors.

How does it work?

Infliximab is a monoclonal antibody that blocks a protein called tumour necrosis factor-alpha (TNF-α). TNF-α is one of the chemical messengers involved in inflammation.

By blocking TNF-α, infliximab reduces inflammation. This can help reduce the pain, swelling and stiffness associated with psoriatic arthritis and can help improve physical function.

Who can get it?

Infliximab is available on prescription for adults with active and progressive psoriatic arthritis when previous treatment with DMARDs has not worked well enough.

It is usually given in combination with methotrexate. However, it can be used on its own if methotrexate is not tolerated or is not suitable.

How is it used?

Infliximab is given by intravenous infusion, usually in a hospital or specialist treatment centre.

The usual dose for psoriatic arthritis is:

• 5 mg for each kilogram of body weight given by infusion
• a further dose at 2 weeks
• another dose at 6 weeks
• then every 8 weeks.

The initial infusions are normally given over about 2 hours. If you have tolerated at least three initial infusions without problems, later infusions may sometimes be given over at least 1 hour. You will be monitored during and after the infusion for possible reactions.

Treatment is normally reviewed to make sure it is working. NICE recommends stopping treatment if there has not been an adequate response after 12 weeks.

What are the side effects?

Like all medicines, infliximab can cause side effects, although not everyone will experience them.

Very common:

• Upper respiratory tract infections, such as sore throat or a runny nose.

Common side effects can include:

• viral infections
• headache
• dizziness or vertigo
• nausea
• abdominal pain
• indigestion
• diarrhoea
• skin reactions or itching
• tiredness
• infusion-related reactions
• reactions at the injection or infusion site
• changes in liver enzymes shown by blood tests.

Infliximab can affect the immune system and increase the risk of infections. Serious infections, including tuberculosis, pneumonia, sepsis and other opportunistic infections, have been reported. Patients are screened for tuberculosis before treatment and monitored for infections during and after treatment.

Infusion-related allergic reactions can occur during or after treatment. These can occasionally be serious. If you develop symptoms such as difficulty breathing, swelling, chest discomfort, severe dizziness or a widespread rash, seek medical attention immediately.

Other important but less common risks include hepatitis B reactivation, heart failure, blood disorders, lupus-like reactions, demyelinating disorders and certain cancers.

How do I get infliximab?

Infliximab is a prescription-only medicine (POM) and treatment is initiated and supervised by specialist healthcare professionals experienced in treating inflammatory diseases.

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Infliximab is known commercially as:

Reviewed: September 2026
Version ID: 2/INF/PAT/09/26

Ixekizumab is a biological medicine used to treat adults with active psoriatic arthritis. It belongs to a group of medicines called interleukin-17A (IL-17A) inhibitors.

It may be used alone or together with methotrexate. In the UK, NICE recommends ixekizumab for certain adults with active psoriatic arthritis when other disease-modifying antirheumatic drugs (DMARDs) have not worked well enough, or when TNF-alpha inhibitors are unsuitable or have not worked. Treatment should be assessed after 16 weeks to make sure it is providing a clear benefit.

How does it work?

Ixekizumab is a monoclonal antibody that blocks the activity of a protein called interleukin-17A (IL-17A). IL-17A is involved in the inflammation that occurs in conditions such as psoriatic arthritis.

By blocking IL-17A, ixekizumab reduces inflammation. This can improve symptoms such as joint pain, swelling and stiffness and can also improve psoriasis. It may also help prevent or slow further damage to the joints.

Who can get it?

Ixekizumab is available on prescription for adults with active psoriatic arthritis who meet the appropriate treatment criteria.

It can be used on its own or together with methotrexate.

NICE recommends ixekizumab for people who have had an inadequate response to other DMARDs, who have not responded adequately to a TNF-alpha inhibitor, or when TNF-alpha inhibitors are unsuitable.

How is it used?

Ixekizumab is given as an injection under the skin (subcutaneous injection).

For psoriatic arthritis without moderate-to-severe plaque psoriasis:

• The first dose is 160 mg (two 80 mg injections).
• This is followed by 80 mg every 4 weeks.

For people with psoriatic arthritis who also have moderate-to-severe plaque psoriasis, the dosing regimen is different:

• 160 mg initially.
• Then 80 mg at weeks 2, 4, 6, 8, 10 and 12.
• After week 12, 80 mg every 4 weeks.

Treatment should be reviewed at 16 weeks. NICE recommends continuing treatment only when there is clear evidence of a response.

What are the side effects?

Like all medicines, ixekizumab can cause side effects, although not everybody gets them.

Very common side effects may include:

• Upper respiratory tract infections, such as a sore throat or stuffy nose
• Injection-site reactions, such as redness or pain

Common side effects may include:

• Fungal infections, such as athlete's foot
• Pain in the back of the throat
• Cold sores (herpes simplex infections)

Uncommon side effects may include:

• Oral thrush
• Influenza
• Runny nose
• Bacterial skin infections
• Hives (urticaria)
• Conjunctivitis
• Low levels of white blood cells (neutropenia)
• Low platelet count (thrombocytopenia)
• Eczema
• Rash
• Swelling of the face, lips, mouth or throat (angioedema)
• Symptoms of inflammatory bowel disease, such as abdominal pain, diarrhoea, weight loss or blood in the stool

Ixekizumab can increase the risk of infections. Patients should tell their doctor if they develop signs of a serious infection.

Serious allergic reactions can also occur. Seek urgent medical attention if there is difficulty breathing or swallowing, or swelling of the face, lips, tongue or throat.

How do I get ixekizumab?

Ixekizumab is available on prescription and is normally initiated and monitored by a specialist.

Marketed by

Ixekizumab is known commercially as Taltz® and is marketed in the UK by Eli Lilly and Company Ltd.

Reviewed: September 2026
Version ID: 2/IXE/PAT/09/26

Secukinumab is a biological medicine used to treat active psoriatic arthritis (PsA). It belongs to a group of medicines called interleukin-17 (IL-17) inhibitors.

Secukinumab may be used when other treatments have not worked well enough or have not been tolerated. It can be used on its own or together with methotrexate. NICE recommends secukinumab as one of the biological or targeted treatments that may be considered for adults with active psoriatic arthritis when previous DMARD treatment has not controlled the condition adequately.

How does it work?

Secukinumab is a monoclonal antibody that specifically blocks a protein called interleukin-17A (IL-17A).

IL-17A is involved in the inflammation that occurs in psoriatic arthritis. By blocking IL-17A, secukinumab reduces inflammation and can help improve symptoms such as joint pain, stiffness and swelling. It can also improve other features of psoriatic arthritis, including psoriasis affecting the skin and nails, and can help improve physical function.

Who can get it?

Secukinumab is available on prescription and is normally prescribed by a specialist.

For adults, it is licensed for active psoriatic arthritis when previous disease-modifying antirheumatic drug (DMARD) treatment has not worked well enough. It can be used alone or in combination with methotrexate.

Secukinumab should not normally be given if you have a clinically important active infection. Your doctor will also consider your medical history, including any history of tuberculosis or inflammatory bowel disease, before starting treatment.

How is it used?

Secukinumab is given as an injection under the skin (subcutaneous injection). You may be taught to inject it yourself, or a healthcare professional or trained caregiver may give the injection.

For most adults with psoriatic arthritis, the recommended dose is:

• 150 mg at weeks 0, 1, 2, 3 and 4
• followed by 150 mg every 4 weeks.

For people with psoriatic arthritis who have had an inadequate response to a TNF-alpha inhibitor, the recommended dose is:

• 300 mg at weeks 0, 1, 2, 3 and 4
• followed by 300 mg every 4 weeks.

A dose of 300 mg is also recommended for people with psoriatic arthritis who have moderate to severe plaque psoriasis. For some other patients, the dose may be increased from 150 mg to 300 mg depending on their response to treatment.

Your doctor will assess your response to treatment. The UK product information states that a clinical response is usually achieved within 16 weeks and treatment should be reconsidered if there has been no response by then.

What are the side effects?

Like all medicines, secukinumab can cause side effects, although not everyone will experience them.

Very common side effects may include:

• upper respiratory tract infections, such as a sore throat or blocked or runny nose.

Common side effects may include:

• cold sores (oral herpes)
• diarrhoea
• runny nose
• fungal infections such as athlete's foot
• headache
• nausea

Uncommon side effects may include:

• oral thrush
• low levels of white blood cells (neutropenia)
• infections affecting the lower respiratory tract
• inflammation or infection of the outer ear
• conjunctivitis
• itchy rash or hives
• inflammatory bowel disease or worsening of existing inflammatory bowel disease.

Seek medical advice promptly if you develop symptoms of a serious infection, such as persistent fever, a cough that does not go away, shortness of breath, or painful, red and swollen skin.

A serious allergic reaction is uncommon but requires immediate medical attention. Symptoms can include difficulty breathing or swallowing, swelling of the face, lips, tongue or throat, dizziness or a severe itchy rash.

Tell your doctor if you develop persistent abdominal pain, diarrhoea or blood in your stools, as these can be symptoms of inflammatory bowel disease.

How do I get secukinumab?

Secukinumab is available only on prescription and is normally initiated and supervised by a specialist.

Marketed by

Secukinumab is known commercially as Cosentyx® and is marketed in the UK by Novartis.

Reviewed: September 2026
Version ID: 2/SEC/PAT/09/26

Ustekinumab is a biological medicine used to treat active psoriatic arthritis in adults when previous disease-modifying antirheumatic drugs (DMARDs) have not worked well enough. It can be used on its own or in combination with methotrexate.

Ustekinumab is also used to treat psoriasis and some inflammatory bowel diseases.

How does it work?

Ustekinumab is a monoclonal antibody that targets two proteins involved in inflammation, called interleukin-12 (IL-12) and interleukin-23 (IL-23).

By blocking these proteins, ustekinumab reduces inflammation. This can help improve symptoms of psoriatic arthritis, including joint pain, stiffness and swelling, and can improve physical function and quality of life. It can also help reduce the progression of damage to the joints.

Who can get it?

Ustekinumab is available on prescription for adults with active psoriatic arthritis when previous non-biological DMARD treatment has not worked well enough.

NICE recommends ustekinumab for active psoriatic arthritis when TNF-alpha inhibitors are unsuitable or when the person has already been treated with one or more TNF-alpha inhibitors.

It can be used alone or together with methotrexate.

How is it used?

Ustekinumab is given as an injection under the skin (subcutaneous injection).

For psoriatic arthritis, the usual dose is:

• 45 mg initially
• 45 mg four weeks later
• then 45 mg every 12 weeks

For people weighing more than 100 kg, the recommended dose is 90 mg initially, followed by 90 mg four weeks later and then every 12 weeks.

You may be taught how to give the injection yourself, or it may be administered by a healthcare professional.

Treatment should be reviewed regularly. Consideration should be given to stopping treatment if there has been no response by 28 weeks.

What are the side effects?

Like all medicines, ustekinumab can cause side effects, although not everybody gets them.

Common side effects (may affect up to 1 in 10 people):

• upper respiratory tract infections, such as sore throat and blocked or runny nose
• headache
• tiredness
• dizziness
• diarrhoea

• itching

• back, muscle or joint pain
• redness or pain where the injection is given

Uncommon side effects (may affect up to 1 in 100 people):

• injection-site reactions such as bruising, swelling, hardness or itching
• depression
• blocked or stuffy nose
• facial palsy (weakness of one side of the face)
• certain changes in psoriasis, including pustular psoriasis

Serious infections can occur, although they are uncommon. Tell your doctor promptly if you develop symptoms of a serious infection, such as persistent fever, a cough that does not go away, or feeling unusually unwell.

Ustekinumab can rarely cause serious allergic reactions. Seek urgent medical attention if you develop swelling of the face, lips, mouth or throat, difficulty breathing or swallowing, or severe dizziness.

How do I get ustekinumab?

Ustekinumab is available on prescription and is normally initiated and monitored by a specialist.

Marketed by

Ustekinumab is known commercially as Stelara and is marketed in the UK by Janssen Ltd

A number of ustekinumab biosimilars are now available, including Imuldosa, Otulfi, Pyzchiva, Steqeyma, Uzpruvo and Wezenla.

Reviewed: September 2026
Version ID: 2/UST/PAT/09/26