Pyzchiva (Ustekinumab-Ttwe) for Psoriasis

Pyzchiva (ustekinumab-ttwe) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat adults and children ages 6 and older with moderate to severe plaque psoriasis.

How Pyzchiva Works and How It’s Taken

Pyzchiva is a monoclonal antibody, a lab-made protein and type of biologic medication. It blocks two immune system proteins called interleukin-12 and interleukin-23. These proteins are involved in inflammation and immune responses.

In plaque psoriasis, this action helps reduce inflammation and the overactive immune response behind skin plaques.

Pyzchiva is a biosimilar of Stelara. This means it is made from living cells and is designed to work like the original medicine. The FDA requires biosimilars to have no meaningful differences in safety or how well they work.

Doctors prescribe Pyzchiva when an adult or child age 6 or older has moderate to severe plaque psoriasis and is a candidate for phototherapy or systemic therapy. Phototherapy uses ultraviolet light to treat psoriasis. Systemic therapy uses medicine that works throughout the body.

Pyzchiva is given as an injection under the skin, typically at the start, again four weeks later, and then every 12 weeks. With proper training and a doctor’s guidance, injections may be given at home.

Typical Dosing for Plaque Psoriasis

The recommended dose of Pyzchiva for plaque psoriasis is:

For adults:

100 kilograms or less — 45 milligrams at the start, 45 milligrams four weeks later, then 45 milligrams every 12 weeks
More than 100 kilograms — 90 milligrams at the start, 90 milligrams four weeks later, then 90 milligrams every 12 weeks

For children ages 6 and older:

Less than 60 kilograms — 0.75 milligrams per kilogram at the start, 0.75 milligrams per kilogram four weeks later, then 0.75 milligrams per kilogram every 12 weeks
60 kilograms to 100 kilograms — 45 milligrams at the start, 45 milligrams four weeks later, then 45 milligrams every 12 weeks
More than 100 kilograms — 90 milligrams at the start, 90 milligrams four weeks later, then 90 milligrams every 12 weeks

This information is based on the prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Pyzchiva Side Effects

In clinical studies of Pyzchiva for moderate to severe plaque psoriasis, the most common side effects occurred in 3 percent to 8 percent of people. These included:

Nasopharyngitis (common cold symptoms, such as a sore throat or runny nose)
Upper respiratory tract infection
Headache
Fatigue (feeling very tired)

Serious Side Effects and Warnings

Pyzchiva can cause serious side effects that may require immediate medical attention. These include:

Serious infections — Tuberculosis and serious bacterial, fungal, or viral infections can occur.
Malignancies — Cancer, including nonmelanoma skin cancer, can occur.
Serious hypersensitivity reactions — Anaphylaxis and angioedema can occur and may cause trouble breathing, swelling, hives, or a rash.
Posterior reversible encephalopathy syndrome (PRES) — This rare brain condition can cause headache, confusion, vision changes, or seizures.
Noninfectious pneumonia — Lung inflammation not caused by an infection can occur, including interstitial pneumonia, eosinophilic pneumonia, or cryptogenic organizing pneumonia. Symptoms may include cough or shortness of breath.

Get medical help right away if you think you are having a serious reaction.

How To Save on Pyzchiva

Sandoz One Source offers the Pyzchiva Co-Pay Program. Eligible people with commercial insurance may pay as little as $0 for Pyzchiva.

Sandoz One Source also offers support services. To learn more, visit the Pyzchiva costs, savings, and support page or call 855-726-3698.

What To Know Before Taking Pyzchiva

Before starting Pyzchiva, your doctor will check you for active and latent (hidden) tuberculosis (TB).

Before starting Pyzchiva, make sure your vaccines are up to date. While taking Pyzchiva, you should avoid live vaccines. You should not receive the BCG vaccine for one year before starting Pyzchiva, during treatment, or for one year after stopping Pyzchiva.

Tell your doctor if anyone in your home needs a live vaccine. Some live vaccines may spread from a household contact to a person taking Pyzchiva.

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.

Before starting Pyzchiva, tell your doctor if you:

Have any open cuts
Are being treated for an infection
Get a lot of infections
Have infections that keep coming back
Have TB
Have been close to someone with TB
Have ever had cancer
Have any new or changing lesions in psoriasis areas or on normal skin
Receive or have received phototherapy for psoriasis
Receive or have received allergy shots

Also tell your doctor if you have had nervous system problems in the past. Tell your doctor right away if you have headache, seizures, confusion, or vision changes.

Do not take Pyzchiva if you are allergic to ustekinumab products or any ingredients in Pyzchiva.

Pyzchiva is also FDA-approved to treat psoriatic arthritis, Crohn’s disease, and ulcerative colitis.

If you are pregnant, planning to become pregnant, or breastfeeding while taking Pyzchiva, talk with your doctor about the risks and benefits.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Pyzchiva for plaque psoriasis?

In two adult plaque psoriasis studies, 67 percent of people taking 45 milligrams of ustekinumab had at least a 75 percent reduction in their PASI score by week 12, compared with 3 percent to 4 percent of people taking a placebo (an inactive treatment). In the same studies, 66 percent to 76 percent of people taking 90 milligrams of ustekinumab reached that level of improvement by week 12.

PASI is a score doctors use to measure psoriasis severity, and PASI 75 means the score decreased by at least 75 percent. In a pediatric study of children ages 12 and older, 80.6 percent reached PASI 75 by week 12, compared with 10.8 percent who received a placebo.

How long does Pyzchiva take to work for plaque psoriasis?

In plaque psoriasis studies, results were measured at week 12. By week 12, more people taking ustekinumab had improved psoriasis scores than people taking placebo.

The studies reported PASI 75 results at week 12 but did not identify the exact earliest time improvement started for each person. They also did not say exactly when people first noticed improvement.

What tests or monitoring are needed with Pyzchiva for plaque psoriasis?

Before starting Pyzchiva, your doctor should check you for TB. Do not take Pyzchiva if you have active TB. If you have latent (inactive) TB, it should be treated before you start Pyzchiva.

People receiving Pyzchiva should be closely monitored and have regular follow-up visits with a healthcare provider. Your doctor should watch for signs and symptoms of infection, active TB, nonmelanoma skin cancer, and PRES. PRES is a rare brain condition that can cause headache, seizures, confusion, or vision problems.