Name of the Procedure:

Ustekinumab Intravenous Injection

• Common Name: Ustekinumab IV
• Medical Term: Ustekinumab for intravenous injection, 1 mg (HCPCS Code: J3358)

Summary

Ustekinumab is an intravenous medication used to treat certain autoimmune conditions by targeting specific proteins in the immune system. It is administered through a vein to help reduce inflammation and manage symptoms associated with these conditions.

Purpose

Medical Conditions:

• Psoriasis
• Psoriatic arthritis
• Crohn's disease
• Ulcerative colitis

Goals/Outcomes:

• Reduce chronic inflammation
• Alleviate symptoms such as pain and swelling
• Improve the quality of life for patients

Indications

Symptoms and Conditions:

• Persistent and severe forms of psoriasis or psoriatic arthritis
• Moderate-to-severe Crohn's disease or ulcerative colitis
• Patients who haven't responded well to other treatments

Patient Criteria:

• Adults and children (usually 12 years or older, depending on specific condition and regulatory guidelines)
• Patients with a confirmed diagnosis of the aforementioned conditions

Preparation

Patient Instructions:

• Inform your doctor of any medications you're currently taking
• May require fasting for a few hours prior to the procedure
• Possible discontinuation of certain medications as advised by the healthcare provider

Diagnostic Tests:

• Blood tests to check liver function and overall health
• Possibly a TB test or other infection screenings

Procedure Description

Step-by-Step:

1. The patient is seated or lying down comfortably.
2. An IV line is inserted into a vein in the arm.
3. Ustekinumab is administered slowly through the IV over a period of time.
4. Monitoring for any immediate adverse reactions during and after the infusion.

Tools and Equipment:

• IV setup (including catheter, tubing, and bag)
• Ustekinumab medication

Anesthesia:

• Typically, no anesthesia or sedation is necessary. Local anesthesia may be used to numb the IV insertion site if needed.

Duration

The infusion process for ustekinumab typically takes about 30 minutes to an hour.

Setting

• Outpatient clinics
• Hospitals
• Specialized infusion centers

Personnel

• Registered Nurse (primarily administering the infusion)
• Physician or specialist overseeing the treatment

Risks and Complications

Common Risks:

• Mild injection-site reactions (redness, itching)
• Headache
• Fatigue

Rare Complications:

• Severe allergic reactions (anaphylaxis)
• Increased risk of infections
• Possible worsening of preexisting conditions

Management:

• Immediate medical intervention for severe reactions
• Close monitoring and follow-up appointments

Benefits

• Reduction in symptoms such as inflammation and pain
• Potential remission of autoimmune disease manifestations
• Improvement in daily functioning and overall well-being

Realization Time:

• Some patients may notice improvements within a few weeks, while for others, it can take months.

Recovery

Post-Procedure Care:

• Observation for a short period after infusion to monitor for adverse reactions
• Regular follow-up appointments to monitor health and treatment efficacy

Recovery Time:

• Most patients can resume normal activities immediately after the infusion
• Minimal restrictions unless specified by the healthcare provider

Alternatives

Other Options:

• Oral or topical medications
• Biological therapies with different mechanisms
• Phototherapy for psoriasis
• Surgical options for severe cases (e.g., bowel resection in Crohn's disease)

Comparison:

• Ustekinumab is often chosen for its targeted action and fewer systemic side effects compared to some alternatives.
• Alternatives may be necessary if the patient doesn’t respond well to Ustekinumab.

Patient Experience

During the Procedure:

• Minor discomfort from the IV insertion
• Generally painless once the IV is in place

After the Procedure:

• Possible mild fatigue or headache
• Instructions for symptom monitoring and when to seek medical attention

Pain Management:

• Mild discomfort at the IV site, which can be managed with over-the-counter pain relievers if necessary.
• Ensuring patient comfort during the infusion to minimize stress and anxiety.