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Drug · FAERS side-effect profile with label screen

Ustekinumab side effects: what 101,629 FDA adverse event reports show

Ustekinumab · 1,265 reaction terms · 574,565 drug–reaction co-reports · data 2026-09-14
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Drug class

Interleukin-12 Antagonist, Interleukin-23 Antagonist

FDA label (Established Pharmacologic Class)

Who reports

101,629 reports · 59% serious · 5,950 with death outcome · 60% female

openFDA FAERS counts, all years, deduplication not applied

Used for

Ustekinumab is a human interleukin-12 and -23 antagonist indicated for the treatment of: Moderate to severe plaque psoriasis in adults and pediatric patients 6 years of age and older who are candidates for phototherapy or systemic therapy. ( 1.1 ) Active psoriatic arthritis in adults and pediatric patients 6 years of age and older.

FDA label, Indications and Usage

What it is

Ustekinumab, a human IgG1κ monoclonal antibody, is a human interleukin-12 and -23 antagonist. Using DNA recombinant technology, ustekinumab is produced in a murine cell line (Sp2/0). The manufacturing process contains steps for the clearance of viruses.

FDA label, Description section

Boxed warning

None in the current label

How to read this page. FAERS is a spontaneous-reporting system: counts are not incidence rates and a signal is not proof of causation. Each reaction below is run through an automated screen — is the term in the FDA label (known), in the indications (the disease being treated), an administrative/coding term, or none of these (unlabeled)? That screen is mechanical text matching, not a causality assessment. The 30 hand-written Bradford Hill assessments are on the causality assessment page. Not medical advice.

Causality screen of the 40 strongest signals

Labeled (related wording) 2Likely indication confounding 1Lab value / disease marker 8Not in label — unassessed 29
What the badges mean

Strongest disproportionality signals

Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only (and, for the 300 most-reported drugs, adjusted for age band), and flags pairs whose reports are unusually skewed by sex or come mostly from consumers. Each row also shows the PRR against the other drugs of the same FDA class, which removes most confounding by the condition being treated, and a calibrated p-value: on validation, known non-causes average an ROR of about 2, so significance is judged against that empirical null (✓ = p < 0.05 after calibration). 1,225 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.

Show:
ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Anti-cyclic citrullinated peptide antibody408328.9
281.1–384.9ROR 330.3 · calibrated p 5e-12 ✓
125.2 EB05 115.3 · IC025 +6.6
3/3 methods agree
Lab value / disease markerserious n=408 · ♀ 100% (drug 60%) · 95% cliniciannot reported in cached trials
Swollen joint count increased1,892322.6
300.1–346.8ROR 328.7 · calibrated p 4e-12 ✓
124.8 EB05 120.2 · IC025 +6.8
3/3 methods agree
Lab value / disease markerserious n=1,891 · ♀ 100% (drug 60%) · 96% cliniciannot reported in cached trials
Rheumatic fever2,495277.9
261.7–295.1ROR 284.8 · calibrated p 2e-11 ✓
117.6 EB05 113.7 · IC025 +6.8
3/3 methods agree
Not in label — unassessedserious n=2,494 · ♀ 100% (drug 60%) · 94% cliniciannot reported in cached trials
Lupus vulgaris661260.2
231.9–292.0ROR 261.9 · calibrated p 4e-11 ✓
114.0 EB05 106.9 · IC025 +6.6
3/3 methods agree
Not in label — unassessedserious n=661 · ♀ 100% (drug 60%) · 96% cliniciannot reported in cached trials
C-reactive protein487241.0
211.3–274.8ROR 242.1 · calibrated p 8e-11 ✓
110.1 EB05 102.1 · IC025 +6.5
3/3 methods agree
Lab value / disease markerserious n=487 · ♀ 100% (drug 60%) · 95% cliniciannot reported in cached trials
Deep vein thrombosis postoperative1,039234.4
214.4–256.3ROR 236.8 · calibrated p 9e-11 ✓
108.9 EB05 103.5 · IC025 +6.6
3/3 methods agree
Not in label — unassessedserious n=1,039 · ♀ 100% (drug 60%) · 94% cliniciannot reported in cached trials
Rheumatoid factor positive2,939215.8
205.0–227.2ROR 222.2 · calibrated p 2e-10 ✓
104.9 EB05 101.7 · IC025 +6.6
3/3 methods agree
Lab value / disease markerserious n=2,936 · ♀ 100% (drug 60%) · 94% cliniciannot reported in cached trials
Swollen joint count125214.4
166.7–275.7ROR 214.6 · calibrated p 4e-10 ✓
103.0 EB05 88.7 · IC025 +5.9
3/3 methods agree
Not in label — unassessedserious n=125 · ♀ 100% (drug 60%) · 100% cliniciannot reported in cached trials
Anti-cyclic citrullinated peptide antibody positive3,572210.0
200.4–219.9ROR 217.6 · calibrated p 2e-10 ✓
103.5 EB05 100.7 · IC025 +6.6
3/3 methods agree
Lab value / disease markerserious PRR 100.7 · ♀ 99% (drug 60%) · 93% cliniciannot reported in cached trials
Grip strength114200.6
154.8–259.9ROR 200.8 · calibrated p 7e-10 ✓
99.6 EB05 85.2 · IC025 +5.8
3/3 methods agree
Not in label — unassessedserious n=114 · ♀ 100% (drug 60%) · 100% cliniciannot reported in cached trials
Red blood cell sedimentation rate127170.2
134.4–215.5ROR 170.4 · calibrated p 3e-9 ✓
91.7 EB05 79.0 · IC025 +5.8
3/3 methods agree
Lab value / disease markerserious n=127 · 92% cliniciannot reported in cached trials
Facet joint syndrome1,380161.2
150.3–173.0ROR 163.4 · calibrated p 2e-9 ✓
90.1 EB05 86.2 · IC025 +6.4
3/3 methods agree
Not in label — unassessedserious n=1,380 · ♀ 100% (drug 60%) · 95% cliniciannot reported in cached trials
Duodenal ulcer perforation3,088150.3
143.5–157.4ROR 155.0 · calibrated p 3e-9 ✓
86.6 EB05 84.1 · IC025 +6.4
3/3 methods agree
Not in label — unassessedserious PRR 84.0 · ♀ 100% (drug 60%) · 93% cliniciannot reported in cached trials
Adjustment disorder with depressed mood846149.7
137.0–163.5ROR 150.9 · calibrated p 5e-9 ✓
86.3 EB05 81.5 · IC025 +6.2
3/3 methods agree
Not in label — unassessedserious n=845 · ♀ 100% (drug 60%) · 96% cliniciannot reported in cached trials
X-ray abnormal725141.5
128.7–155.5ROR 142.5 · calibrated p 7e-9 ✓
83.5 EB05 78.5 · IC025 +6.2
3/3 methods agree
Lab value / disease markerserious n=725 · ♀ 100% (drug 60%) · 97% cliniciannot reported in cached trials
Subcutaneous drug absorption impaired215134.7
113.4–160.0ROR 135.0 · calibrated p 1e-8 ✓
80.7 EB05 72.1 · IC025 +5.9
3/3 methods agree
Not in label — unassessedserious n=215 · ♀ 100% (drug 60%) · 100% cliniciannot reported in cached trials
Retinitis637127.5
115.5–140.8ROR 128.3 · calibrated p 2e-8 ✓
78.4 EB05 73.4 · IC025 +6.1
3/3 methods agree
Not in label — unassessedserious n=637 · ♀ 100% (drug 60%) · 93% cliniciannot reported in cached trials
Ileocaecal resection121118.3
94.5–148.0ROR 118.4 · calibrated p 4e-8 ✓
74.2 EB05 63.7 · IC025 +5.5
3/3 methods agree
Not in label — unassessedserious n=121 · 100% cliniciannot reported in cached trials
Dislocation of vertebra798115.5
105.9–126.0ROR 116.4 · calibrated p 4e-8 ✓
73.8 EB05 69.6 · IC025 +6.0
3/3 methods agree
Not in label — unassessedserious n=798 · ♀ 100% (drug 60%) · 95% cliniciannot reported in cached trials
Sleep disorder due to general medical condition, hypersomnia type3296.7
63.4–147.3ROR 96.7 · calibrated p 5e-7 ✓
63.4 EB05 47.0 · IC025 +4.5
3/3 methods agree
Not in label — unassessedserious n=32 · ♀ 100% (drug 60%) · 100% cliniciannot reported in cached trials
Neurologic neglect syndrome17593.7
78.3–112.1ROR 93.8 · calibrated p 2e-7 ✓
63.9 EB05 56.4 · IC025 +5.5
3/3 methods agree
Not in label — unassessedserious n=175 · ♀ 100% (drug 60%) · 93% cliniciannot reported in cached trials
Helicobacter infection3,18393.6
89.8–97.6ROR 96.6 · calibrated p 1e-7 ✓
64.3 EB05 62.5 · IC025 +5.9
3/3 methods agree
Not in label — unassessedserious PRR 65.9 · ♀ 99% (drug 60%) · 93% cliniciannot reported in cached trials
Pemphigus3,86793.1
89.7–96.7ROR 96.8 · calibrated p 1e-7 ✓
64.1 EB05 62.4 · IC025 +5.9
3/3 methods agree
Not in label — unassessedserious PRR 62.3 · ♀ 100% (drug 60%) · 92% cliniciannot reported in cached trials
Hand deformity3,97089.8
86.6–93.2ROR 93.4 · calibrated p 2e-7 ✓
62.5 EB05 60.9 · IC025 +5.9
3/3 methods agree
Not in label — unassessedserious PRR 65.9 · ♀ 99% (drug 60%) · 93% cliniciannot reported in cached trials
C-reactive protein abnormal1,76578.3
74.2–82.7ROR 79.7 · calibrated p 6e-7 ✓
56.7 EB05 54.5 · IC025 +5.7
3/3 methods agree
Lab value / disease markerserious n=1,765 · ♀ 91% (drug 60%) · 94% cliniciannot reported in cached trials
Muscle injury2,15773.4
69.9–77.1ROR 75.0 · calibrated p 9e-7 ✓
54.1 EB05 52.2 · IC025 +5.7
3/3 methods agree
Not in label — unassessedserious PRR 56.8 · ♀ 99% (drug 60%) · 94% cliniciannot reported in cached trials
Sleep disorder due to general medical condition, insomnia type1,63269.9
66.1–74.0ROR 71.1 · calibrated p 1e-6 ✓
52.2 EB05 50.1 · IC025 +5.6
3/3 methods agree
Not in label — unassessedserious n=1,632 · ♀ 100% (drug 60%) · 95% cliniciannot reported in cached trials
Synovitis4,56469.7
67.4–72.1ROR 72.9 · calibrated p 1e-6 ✓
52.1 EB05 50.8 · IC025 +5.6
3/3 methods agree
Not in label — unassessedserious PRR 52.9 · ♀ 94% (drug 60%) · 92% cliniciannot reported in cached trials
Seronegative arthritis27968.1
59.5–78.0ROR 68.3 · calibrated p 2e-6 ✓
51.0 EB05 46.2 · IC025 +5.4
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
serious n=279 · ♀ 100% (drug 60%) · 95% cliniciannot reported in cached trials
Folliculitis2,54467.3
64.4–70.3ROR 69.0 · calibrated p 2e-6 ✓
50.7 EB05 49.1 · IC025 +5.6
3/3 methods agree
Not in label — unassessedserious PRR 57.4 · ♀ 99% (drug 60%) · 94% clinicianNCT01708603: 1/300 (0.3%) on Ustekinumab
Pericarditis3,80560.9
58.8–63.1ROR 63.2 · calibrated p 3e-6 ✓
47.0 EB05 45.8 · IC025 +5.5
3/3 methods agree
Not in label — unassessedserious PRR 46.0 · ♀ 99% (drug 60%) · 93% cliniciannot reported in cached trials
Bone erosion76756.9
52.5–61.6ROR 57.3 · calibrated p 6e-6 ✓
44.6 EB05 42.0 · IC025 +5.3
3/3 methods agree
Not in label — unassessedserious n=767 · ♀ 96% (drug 60%) · 93% cliniciannot reported in cached trials
Ileectomy7255.6
42.8–72.2ROR 55.7 · calibrated p 1e-5 ✓
43.4 EB05 35.6 · IC025 +4.7
3/3 methods agree
Not in label — unassessedserious n=72not reported in cached trials
Carotid artery thrombosis17753.8
45.6–63.5ROR 53.9 · calibrated p 1e-5 ✓
42.5 EB05 37.5 · IC025 +5.0
3/3 methods agree
Not in label — unassessedserious n=177 · ♀ 100% (drug 60%) · 93% cliniciannot reported in cached trials
Hypocholesterolaemia5746.7
35.0–62.3ROR 46.7 · calibrated p 3e-5 ✓
37.7 EB05 30.2 · IC025 +4.4
3/3 methods agree
Not in label — unassessedserious n=57 · ♀ 100% (drug 60%) · 100% cliniciannot reported in cached trials
Proctocolectomy5444.6
33.2–59.9ROR 44.6 · calibrated p 4e-5 ✓
36.3 EB05 28.9 · IC025 +4.3
3/3 methods agree
Not in label — unassessedserious n=54not reported in cached trials
Glossodynia (burning tongue/mouth pain)3,97444.5
43.0–46.0ROR 46.2 · calibrated p 2e-5 ✓
36.6 EB05 35.7 · IC025 +5.1
3/3 methods agree
Not in label — unassessedserious PRR 51.4 · ♀ 100% (drug 60%) · 93% cliniciannot reported in cached trials
Granuloma skin14342.9
35.8–51.3ROR 42.9 · calibrated p 4e-5 ✓
35.4 EB05 30.8 · IC025 +4.7
3/3 methods agree
Not in label — unassessedserious n=143 · 91% cliniciannot reported in cached trials

Clinical concept groups

MedDRA splits one clinical problem across several terms (e.g. "neutropenia", "neutrophil count decreased", "agranulocytosis"), which dilutes term-level signals. These rows count reports with any term in a concept group (an exact union, not a sum), compared with all other drugs. Groups are hand-built and listed in the methods.

ConceptReportsPRR 95% CIReading
Liver injury6,0834.24.1–4.3signal
Interstitial lung disease1,4103.12.9–3.2signal
Serious infection9,3602.52.5–2.6signal
Tendon disorder3882.11.9–2.3raised
Hyperglycaemia / diabetes3,3512.01.9–2.1raised
Opportunistic infection1,0621.61.5–1.7raised
Pancreatitis5931.51.4–1.6raised
Malignancy2,5841.41.4–1.5raised
Depression1,8521.41.3–1.4raised
Stroke1,0540.90.8–0.9lower than other drugs
Anaphylaxis / angioedema5170.80.8–0.9lower than other drugs
Rhabdomyolysis / myopathy3200.80.7–0.9lower than other drugs
Gi bleeding7190.80.8–0.9lower than other drugs
Fall / fracture1,3920.80.7–0.8lower than other drugs
Myocardial infarction6510.70.6–0.7lower than other drugs
Venous thromboembolism6030.60.5–0.6lower than other drugs

Trial evidence (ClinicalTrials.gov)

✓ Trial adverse-event data found on ClinicalTrials.gov

Largest completed trials with posted results that list Ustekinumab as a study intervention. The right-hand column of the signal table shows whether each FAERS term was also recorded in these trials, with a real denominator (1 of 40 signal terms matched).

Caveats: trial populations, doses and follow-up differ from the reporting population; AE terms are sponsor-coded and matched here by wording; absence from a trial list means the term was not reported above the sponsor's frequency threshold, not that it cannot occur.

Most frequently reported reactions

By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.

ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Drug ineffective (drug did not work)14,7822.3
2.3–2.4ROR 2.6 · calibrated p 0.790
2.3 EB05 2.3 · IC025 +1.2
3/3 methods agree
Reporting / coding artifactage-adj. PRR 2.4 · serious PRR 4.1not reported in cached trials
Off label use (used outside approved label)12,6853.0
3.0–3.1ROR 3.3 · calibrated p 0.527
3.0 EB05 3.0 · IC025 +1.6
3/3 methods agree
Reporting / coding artifactage-adj. PRR 3.4 · serious PRR 3.7not reported in cached trials
Product dose omission issue10,0837.5
7.4–7.7ROR 8.3 · calibrated p 0.060
7.3 EB05 7.2 · IC025 +2.8
3/3 methods agree
Reporting / coding artifactage-adj. PRR 7.9 · serious PRR 2.6not reported in cached trials
Fatigue (tiredness)6,8381.8
1.8–1.9ROR 1.9 · calibrated p 0.877
1.8 EB05 1.8 · IC025 +0.8Labeled adverse reaction
exact term
age-adj. PRR 1.8 · serious PRR 2.9 · ♀ 87% (drug 60%)NCT01708629: 4/313 (1.3%) on Ustekinumab; 6/315 (1.9%) control
Psoriasis6,57310.9
10.6–11.1ROR 11.5 · calibrated p 0.019 ✓
10.4 EB05 10.1 · IC025 +3.3
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
age-adj. PRR 10.2 · serious PRR 16.9NCT01708629: 1/315 (0.3%) control (serious AE)
Pain6,2232.1
2.0–2.1ROR 2.2 · calibrated p 0.968
2.1 EB05 2.0 · IC025 +1.0
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 2.1 · serious PRR 2.8 · ♀ 87% (drug 60%)NCT01708629: 6/313 (1.9%) on Ustekinumab; 3/315 (1.0%) control
Arthralgia (joint pain)5,8252.9
2.9–3.0ROR 3.0 · calibrated p 0.613
2.9 EB05 2.8 · IC025 +1.5
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 2.7 · serious PRR 4.3 · ♀ 82% (drug 60%)NCT01708629: 10/313 (3.2%) on Ustekinumab; 6/315 (1.9%) control
Rash5,6272.7
2.6–2.8ROR 2.8 · calibrated p 0.696
2.7 EB05 2.6 · IC025 +1.4
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 2.6 · serious PRR 5.1 · ♀ 90% (drug 60%)NCT01708629: 1/629 (0.2%) on Ustekinumab (serious AE)
Product use issue5,4226.1
6.0–6.3ROR 6.4 · calibrated p 0.126
6.0 EB05 5.8 · IC025 +2.5
3/3 methods agree
Reporting / coding artifactage-adj. PRR 7.4 · serious PRR 11.1not reported in cached trials
Headache5,2811.7
1.7–1.8ROR 1.8 · calibrated p 0.821
1.7 EB05 1.7 · IC025 +0.8Labeled adverse reaction
exact term
age-adj. PRR 1.6 · serious PRR 2.9 · ♀ 82% (drug 60%)NCT01708629: 11/313 (3.5%) on Ustekinumab; 14/315 (4.4%) control
Condition aggravated5,2233.6
3.5–3.7ROR 3.8 · calibrated p 0.427
3.6 EB05 3.5 · IC025 +1.8
3/3 methods agree
Reporting / coding artifactage-adj. PRR 2.8 · serious PRR 4.2 · ♀ 84% (drug 60%)not reported in cached trials
Infusion related reaction (reaction during infusion)5,14517.3
16.9–17.8ROR 18.2 · calibrated p 0.003 ✓
16.1 EB05 15.7 · IC025 +4.0
3/3 methods agree
Not in label — unassessedage-adj. PRR 14.3 · serious PRR 18.6 · ♀ 93% (drug 60%)not reported in cached trials
Rheumatoid arthritis4,8349.2
8.9–9.4ROR 9.6 · calibrated p 0.037 ✓
8.8 EB05 8.6 · IC025 +3.1
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
age-adj. PRR 8.8 · serious PRR 10.4 · ♀ 97% (drug 60%)not reported in cached trials
Joint swelling4,7258.4
8.1–8.6ROR 8.7 · calibrated p 0.050
8.1 EB05 7.9 · IC025 +3.0
3/3 methods agree
Not in label — unassessedage-adj. PRR 7.5 · serious PRR 13.3 · ♀ 94% (drug 60%)NCT01708603: 1/612 (0.2%) on Ustekinumab; 1/309 (0.3%) control
Diarrhoea (diarrhea)4,6751.5
1.5–1.5ROR 1.5 · calibrated p 0.658
1.5 EB05 1.5 · IC025 +0.5Labeled adverse reaction
exact term
age-adj. PRR 1.7 · serious PRR 2.2NCT01708629: 3/313 (1.0%) on Ustekinumab; 4/315 (1.3%) control

Unlabeled candidate signals

These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.

Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.

Common questions

What are the most reported side effects of Ustekinumab?

In FDA FAERS, the most frequently co-reported reaction terms for Ustekinumab are fatigue, psoriasis, pain, arthralgia, rash, headache. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.

Does Ustekinumab have an FDA boxed warning?

No. The FDA label retrieved for Ustekinumab has no boxed warning; see the label's Warnings and Precautions for the recognised risks.

Do FAERS signals prove that Ustekinumab causes these side effects?

No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.

Sources & methods

Page generated 2026-10-14. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.