ustekinumab + methotrexate

Ustekinumab + methotrexate is a combination therapy used primarily for the treatment of active psoriatic arthritis, especially in patients who do not respond adequately to monotherapy. Ustekinumab is a monoclonal antibody that targets the p40 subunit shared by interleukin-12 (IL-12) and interleukin-23 (IL-23), thereby inhibiting their interaction with cell surface receptors and suppressing inflammatory pathways mediated by Th1 and Th17 cells. Methotrexate is a conventional disease-modifying antirheumatic drug (DMARD) that inhibits dihydrofolate reductase, interfering with DNA synthesis and immune cell proliferation. The combination can be effective and well tolerated for patients requiring enhanced control of psoriatic arthritis or psoriasis, but may increase the risk of serious infections[2][3][4][5][8].