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PAD Profile : Ustekinumab - Inflammatory bowel disease Important
Traffic Light Status
Status 1 of 1.
Guidelines
The following guidelines are available for this indication.
Other Drugs
- Adalimumab
- Azathioprine
- Infliximab
- Mercaptopurine
- Ciclosporin
- Golimumab
- Vedolizumab
- Allopurinol
- Balsalazide sodium
- Prednisolone
- Budesonide
- Tofacitinib
- Methotrexate
- Mesalazine (Systemic)
- Filgotinib
- Sulfasalazine
- Upadacitinib
- Risankizumab
- Olsalazine sodium
Other Indications
- Wet age-related macular degeneration
- Lambert-Eaton myasthenic syndrome (LEMS)
- Respiratory distress in preterm neonates
- Pain
- Diabetic retinopathy
- Osteoarthritis
- Constipation
- Respiratory distress in preterm neonates
- Hepatic encephalopathy
- Travellers diarrhoea
- Penile rehabilitation
- Erectile dysfunction
- Cytomegalovirus
- Hyperuricaemia and Gout
- Vitreomacular traction
- Central retinal vein occlusion
- Peripheral arterial disease
- Dysphagia
- Diabetic macular oedema
- Diarrhoea
- Haemorrhoids
- Heart failure
- Oedema
- Lipid modification
- Haemophilia
- Cataracts
- Branch retinal vein occlusion
- Low sexual desire in menopausal women
- Hypertension
- Hypertension
- Hypertension
- Bacterial infection
- Psoriasis
- Atopic dermatitis
- Multiple sclerosis
- Myopic choroidal neovascularisation
- Cystic fibrosis
- Fungal infection
- Duchenne muscular dystrophy
- Cystic fibrosis
- Hepatitis C
- Tuberculosis
- Hepatitis C
- Multiple sclerosis
- Tuberculosis
- Hepatitis C
- Hepatitis C
- Hepatitis C
- Haemophilia
- Cystic fibrosis
- Hepatitis C
- Systemic Lupus Erythematosus
- Hepatitis C
- Inclusion body myositis
- Cytomegalovirus
- Asthma
- Haemophilia
- Systemic Lupus Erythematosus
- Duchenne muscular dystrophy
- Hepatitis C
- Haemophilia
- Systemic Lupus Erythematosus
- Haemophilia
- Haemophilia
- Haemophilia
- Haemophilia
- Multiple sclerosis
- Hepatitis B
- Haemophilia
- Short bowel syndrome
- Haemophilia
- Any paediatric use
- von Willebrand deficiency
- Haemophilia
- Haemophilia
- Erectile dysfunction combination therapy
- Children and young people with Epilepsy
- Mental Health disorders
- Mental Health disorders
- Inflammatory bowel disease
- Acne
- Diabetes Mellitus
- Interface Prescribing Policy (IPP)
- Non-acne dermatological indications
- Anticoagulation reversal
- Restless Leg Syndrome
- von Willebrand deficiency
- Smoking cessation
- Immune thrombocytopenia
- Wet age-related macular degeneration
- Bacterial skin and skin structure infections
- Cystic fibrosis
- Narcolepsy
- Bacterial lung infection (non-cystic fibrosis)
- Lipid modification
- Menopausal disorders
- All
- Raynaud's Phenomenon
- Atopic dermatitis
- Psoriasis
- Clostridioides difficile
- Hereditary angiodema
- Covid-19
- Covid-19
- Covid-19
- Peanut allergy in children and young people
- Inflammatory bowel disease
- Growth failure - children
- Inflammatory bowel disease
- Diabetic macular oedema
- Wet age-related macular degeneration
- Diabetic macular oedema
- Migraine (prevention)
- Urinary incontinence
- Immune thrombocytopenia
- Glaucoma / ocular hypertension
- Dry eyes
- Cancer
- Diarrhoea
- Inflammatory bowel disease
- Non-radiographic axial spondyloarthritis
- Photoaggravated dermatoses
- Photodermatoses
- Metabolic disorders
- Insomnia in adults
- Cardiomyopathy
- Epidermolysis bullosa
- Photoaggravated dermatoses
- Psoriasis
- Psoriatic arthritis
- Photodermatoses
- Photodermatoses
- Photoaggravated dermatoses
- Catheter maintenance solutions
- Dry eyes
- Dry eyes
- Dry eyes
- Dry eyes
- Dry eyes
- Dysphagia
- Prurigo nodularis
- Vitamin D deficiency and insufficiency
- Osteoporosis
- Migraine (prevention)
- Pain
- Ankylosing spondylitis
- Non-radiographic axial spondyloarthritis
- Pustular psoriasis
- Mucus clearance
- Atopic dermatitis
- Alopecia
- Asthma
- Chronic Obstructive Pulmonary Disease (COPD)
- Smoking cessation
- Pain
- Homozygous familial hypercholesterolaemia
- Asthma
- Chronic Obstructive Pulmonary Disease (COPD)
- Metabolic disorders
- Concious sedation
- Premedication
- post Bariatric surgery
- Erectile dysfunction
- Parkinson's disease
- Myasthenia gravis
- Bacterial infection
- Bacterial infection
- Bacterial infection
- Bacterial infection
- Bacterial infection
- Bacterial infection
- Bacterial infection
- Tuberculosis
- Tuberculosis
- Tuberculosis
- Covid-19
- Inflammatory bowel disease
- Rehydration in short bowel syndrome
- Faecal impaction (adults)
- Faecal impaction (children)
- Minor digestive complaints
- Haemorrhoids
- Haemorrhoids
- Menopausal disorders
- Menopausal disorders
- Menopausal disorders
- Menopausal disorders
- Menopausal disorders
- Menopausal disorders
- Menopausal disorders
- Menopausal disorders
- Nutrition (Infant)
- Nutrition (Infant)
- Nutrition (Infant)
- Nutrition (Infant)
- Nutrition (Infant)
- Nutrition (Infant)
- Nutrition (Infant)
- Nutrition (Infant)
- Nutrition (Infant)
- Nutrition (Infant)
- Nutrition (Infant)
- Nausea and vomiting
- Agitation in mania and psychotic disorders
- Schizophrenia
- Intraoperative mydriasis / prevention of miosis
- Stoma
- Arrhythmias
- Acute coronary syndrome
- Acute coronary syndrome
- Inotropic support
- IV catheter maintenance
- Cardiopulmonary resuscitation
- Hepatitis D
- Hypertension (severe / crisis)
- Heart failure
- Oedema
- Hypotension
- Tissue glue / suture support
- Diagnosis of Brugada syndrome
- Heparin induced thrombocytopenia
- HIV infection
- Stoma
- Stoma
- Stoma
- Stoma
- Stoma
- Stoma
- Stoma
- Stoma
- Stoma
- Smoking cessation
- Endometriosis
- Surgical diagnostic
- Ocular surgery
- Chronic Obstructive Pulmonary Disease (COPD)
- Growth failure - adults
- Growth failure - children
- Oesophagitis (inducing remission)
- Uterine fibroids
- Overactive bladder (adults)
- Retinal Vein Occlusion
- Hidradenitis suppurativa
- Alzheimers disease
- Alzheimers disease
- Osteoporosis
- Allergen immunotherapy
- Premedication
- Local anaesthesia
- Hereditary angiodema
- Hereditary angiodema
- Status epilepticus
Additional Documents
Committee Recommendations
The Surrey Heartlands Integrated Care System Area Prescribing Committee has agreed the reviewed and updated IBD immunomodulator pathway, which is to be found here - https://surreyccg.res-systems.net/PADFormularyV1Admin/Profile/Detail/7986
ULCERATIVE COLITIS
The Surrey & North West Sussex Area Prescribing Committee recommends ustekinumab for treating moderately to severely active ulcerative colitis in line with NICE TA633.
The Area Prescribing Committee also agreed an update of treatment pathway 4 (high cost immunomodulator) for use in Inflammatory Bowel Disease. The Crohn's Disease Pathway and the Ulcerative Colitis Pathway are now incorporated into one document
CROHN'S DISEASE
The Surrey and North West Sussex Area Prescribing Committee recommends that ustekinumab in patients with moderately to severely active Crohn’s Disease, may be dose optimised to 8 weekly when a patient starts to lose response to standard (12 weekly) dosing. Dose optimisation will be for a 16 week treatment course to recapture response.
Patients must return to standard dosing (ustekinumab 12 weekly) after the 16 week course has been completed.
If the patient loses response to the standard dosing within a short time period (12 weeks) then the provider can apply for maintenance funding to return to the escalated dose (8 weekly).
Gastroenterologists can repeat the 16 week course if the patient starts to lose response after returning to 12 weeks of standard dosing.
Ustekinumab is a payment by results excluded drug and will be considered RED on the traffic light system.
Gastroenterology specialists will be required to complete blueteq initiation and continuation forms for the commissioners.
Primary care prescribers should ensure that patient medication records include any medicine for which prescribing remains the responsibility of secondary or tertiary care. This will ensure that GP records, which are accessed by other healthcare providers, are a true and accurate reflection of the patient’s medication
CROHN'S DISEASE
The PCN recommends Ustekinumab as a treatment option for treating moderately to severely active Crohn’s Disease in line with NICE and the associated treatment pathway. Prescribing will be by hospital specialists only, in line with NICE TA456 using Blueteq initiation and continuation forms. Ustekinumab will be considered RED on the traffic light system