Vascular Inflammation in Psoriasis-Ustekinumab (VIP-U)

Inclusion Criteria:

1. Males and females 18 years of age and older.

2. Clinical diagnosis of psoriasis for at least 6 months as determined by subject
interview of his/her medical history and confirmation of diagnosis through physical
examination by Investigator.

3. Stable plaque psoriasis for at least 2 months before Screening and at Baseline (Week
0) as determined by subject interview of his/her medical history.

4. Moderate to severe psoriasis defined by ≥ 10 percent Body Surface Area (BSA)
involvement at the Baseline (Week 0) visit.

5. PASI score of ≥ 12 at the Baseline (Week 0) visit.

6. Subject is a candidate for systemic therapy and has active psoriasis despite prior
treatment with topical agents.

7. Women are eligible to participate in the study if they meet one of the following
criteria:

1. Women of childbearing potential who are willing to undergo periodic pregnancy
testing during the study and agree to use at least one method of contraception
throughout the study duration and for at least 15 weeks after the last dose of
the study drug are eligible to participate.

2. Women who are postmenopausal (for at least one year), sterile, or hysterectomized
are eligible to participate.

3. Women who have undergone tubal ligation are eligible to participate.

4. Women who agree to be sexually abstinent, defined as total abstinence from sexual
intercourse, as a form of contraception, are eligible to participate.

8. Men are eligible to participate in the study if they meet one of the following
criteria:

1. Agree to use a proven birth control method during the study and for at least 15
weeks after the last dose of the study drug.

2. Have a female partner who agrees to use at least one method of contraception
throughout the study duration and for at least 15 weeks after the last dose of
the study drug.

3. Have a female partner who is postmenopausal (for at least one year), sterile, or
hysterectomized;

4. Have a female partner who has undergone tubal ligation,

5. Agree to be sexually abstinent, defined as total abstinence from sexual
intercourse, as a form of contraception.

9. Subject is judged to be in good general health as determined by the Principal
Investigator based upon the results of medical history, laboratory profile, physical
examination, and 12-lead electrocardiogram (ECG) performed at screening.

10. Able and willing to give written informed consent and to comply with requirements of
this study protocol.

Exclusion Criteria:

1. Previous adverse event following exposure to an IL-12/IL-23 antagonist that led to
discontinuation of therapy and contraindicates future treatment.

2. Previous lack of response to an IL-12/IL-23 antagonist that led to discontinuation of
therapy.

3. Diagnosis of erythrodermic psoriasis, generalized or localized pustular psoriasis,
medication-induced or medication-exacerbated psoriasis, or new onset guttate
psoriasis.

4. Diagnosis of other active skin diseases or skin infections (bacterial, fungal, or
viral) that may interfere with evaluation of psoriasis.

5. Cannot avoid UVB phototherapy or Excimer laser for at least 14 days prior to the
Baseline (Week 0) visit and during the study.

6. Cannot avoid psoralen-UVA phototherapy for at least 30 days prior to the Baseline
(Week 0) visit and during the study.

7. Cannot discontinue systemic therapies for the treatment of psoriasis, or systemic
therapies known to improve psoriasis, during the study:

- Systemic therapies must be discontinued at least 30 days prior to the Baseline
(Week 0) visit except for biologics.

- All biologics, except ustekinumab, must be discontinued for at least 90 days
prior to Baseline (Week 0).

- Any IL-12/IL-23 antagonist (e.g., ustekinumab, briakinumab) must be
discontinued for at least 180 days prior to Baseline (Week 0).

- Investigational agents must be discontinued at least 30 days or 5 half-lives
(whichever is longer) prior to the Baseline (Week 0) visit.

8. Subject is taking or requires oral or injectable corticosteroids during the study.
Inhaled corticosteroids for stable medical conditions are allowed.

9. Poorly controlled medical condition, such as unstable ischemic heart disease,
cerebrovascular accident or myocardial infarction within the prior 6 months,
psychiatric disease requiring frequent hospitalization, and any other condition,
which, in the opinion of the Investigator, would put the subject at risk by
participation in the study.

10. History of diabetes mellitus, type 1 or type 2 with the exception that patients with
type 2 diabetes may be enrolled if the duration of diabetes is <10 years and HbA1c is
<7.0%.

11. Uncontrolled hypertension, with measured systolic blood pressure >180 mmHg or
diastolic blood pressure >90 mmHg

12. Subject has infection or risk factors for severe infections, for example:

- Positive serology or known history of HIV, hepatitis B or C, or other severe,
recurrent, or persistent infections;

- Excessive immunosuppression or other factors associated with it, including human
immunodeficiency virus infection;

- Active tuberculosis (TB) disease;

- Evidence of latent TB infection demonstrated by positive Quantiferon-GOLD result;
except if prophylactic treatment for TB, as recommended by local guidelines, is
initiated prior to administration of study drug or if there is documentation that
the subject has received prophylactic treatment for TB within 3 years prior to
the first administration of study agent.

- Any other significant infection requiring hospitalization or intravenous (IV)
antibiotics in the month prior to Baseline;

- Infection requiring treatment with oral or parenteral (other than IV) antibiotics
within 14 days prior to Baseline;

- Subject has received vaccination with Bacille Calmette-Guerin (BCG) within 365
days prior to Screening or will receive BCG vaccination during study
participation including up to 12 months after the last dose of the study drug;

- Subject has received vaccination with a live viral agent 30 days prior to
Screening or will require a live vaccination during study participation including
up to 3 months after the last dose of study drug.

13. Subject has history of hematological or solid malignancy within the past five years
other than successfully treated basal cell carcinoma, non-metastatic cutaneous
squamous cell carcinoma or cervical carcinoma in situ.

14. Female subject who is pregnant or breast-feeding or considering becoming pregnant
during the study.

15. Male subject who is considering fathering a child during the study.

16. Screening clinical laboratory analyses showing any of the following abnormal results:

- Hemoglobin (Hgb) < 10 g/dL in females or <12 g/dL in males;

- White blood cell (WBC) count <2.5 x 109/L

o Subject can be included if WBC count is <2.5 x 109/L and absolute neutrophil
count (ANC) is >1000 cells / mm3.

- WBC count > 15 x 109/L;

- Platelet count < 100 x 109/L;

- Serum creatinine >1.6 mg/dL (>141 µmol/L);

- Serum aspartate transaminase (AST) or alanine transaminase (ALT) >2.5 upper
limits of normal (ULN);

- Serum total bilirubin ≥2 mg/dL (≥26 µmol/L)

17. Recent history of substance abuse or psychiatric illness that could preclude
compliance with the protocol.

18. History of any substance abuse within 365 days of screening visit

19. Alcohol use >14 drinks per week at the screening visit or within 30 days of the
screening period

20. If subject is on cholesterol-lowering medication (e.g. statin), dose and form of
medication must be stable for 90 days prior to week 0 and remain stable throughout the
duration of the study.