Starjemza (Ustekinumab-Hmny) for Psoriasis

Starjemza (ustekinumab-hmny) 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 Starjemza Works and How It's Taken

Starjemza is a type of biologic medication called a monoclonal antibody. It works by blocking two immune system proteins called interleukin-12 and interleukin-23, which helps reduce inflammation and slow the overactive immune signals that lead to skin plaques.

Starjemza 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 Starjemza when adults or children ages 6 and older have moderate to severe plaque psoriasis and are candidates for phototherapy or systemic therapy. Phototherapy means treatment with ultraviolet light. Systemic therapy means medicine that works throughout the body.

Starjemza is given as an injection under the skin. It is given at the start, again four weeks later, and then every 12 weeks.

Starjemza should be used under the guidance and supervision of a healthcare provider. In children, it is recommended that a healthcare provider give the injection. The person receiving Starjemza or a caregiver may give the injection at home if a healthcare provider decides this is appropriate and provides proper training.

Starjemza can be injected under the skin in the upper arms, buttocks, thighs, or stomach area. Do not inject it into skin that is tender, bruised, discolored, or hard. Use a different injection site each time.

Typical Dosing for Plaque Psoriasis

The recommended dose of Starjemza 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.

Starjemza Side Effects

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

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

Starjemza 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 rash.
Posterior reversible encephalopathy syndrome (PRES) — This rare brain condition can cause headache, confusion, vision changes, or seizures.
Noninfectious pneumonia — Types include interstitial pneumonia, eosinophilic pneumonia, and cryptogenic organizing pneumonia, which can cause cough or shortness of breath.

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

What To Know Before Taking Starjemza

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

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

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 Starjemza.

Tell your doctor if you have any allergies to ustekinumab-hmny or any ingredients in Starjemza.

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

Before starting Starjemza, tell your doctor if you think you have an infection or have symptoms of infection.

Also 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 headaches, seizures, confusion, or vision changes.

Do not take Starjemza if you have had a clinically significant allergic reaction to ustekinumab products or any of the ingredients in Starjemza.

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

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

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Starjemza for plaque psoriasis?

In two studies of adults with plaque psoriasis, ustekinumab was compared with placebo (an inactive treatment). By week 12, 67 percent to 76 percent of people taking ustekinumab reached Psoriasis Area and Severity Index (PASI) 75, meaning their psoriasis score improved by at least 75 percent. In comparison, 3 percent to 4 percent of people taking placebo reached PASI 75.

By week 12, 59 percent to 73 percent of people taking ustekinumab were rated as "cleared" or "minimal" on the Physician's Global Assessment. This is a doctor's rating of psoriasis severity. In comparison, 4 percent of people taking placebo were rated as "cleared" or "minimal."

How long does Starjemza take to work for 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 responses at week 12.

PASI 75 means the psoriasis score improved by at least 75 percent. The studies do not say the exact earliest time when improvement starts for each person. They also do not say exactly when people first notice improvement in plaque psoriasis.

What tests or monitoring are needed with Starjemza for psoriasis?

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

People receiving Starjemza 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 headaches, seizures, confusion, or vision problems.