Guselkumab (Tremfya)


Guselkumab is indicated for the treatment of adults with moderate to severe plaque psoriasis who are candidates for systemic therapy or phototherapy.



Tradename Tremfya.



It is indicated for the treatment of adults with active psoriatic arthritis.



Serious hypersensitivity reactions, including anaphylaxis, have been reported.



It may increase the risk of infection, and should not be initiated in patients with a clinically important active infection.



Patients should be evaluated for tuberculosis prior to the initiation of treatment.



Prior to the initiation of treatment patient should be evaluated for current immunization guidelines.



Adverse reactions include:  upper respiratory infections, headache, injection site reactions, arthralgia, bronchitis, diarrhea, gastroenteritis, tinea infections, and herpes simplex infections.



It is administered as a 100 mg subcutaneous injection once every 8 weeks, after starter doses at weeks 0 and 4. 



It may be administered alone or in combination with a cDMARD


A monoclonal antibody used to treat plaque psoriasis.

Sold under the trade name Tremfya.

Targets IL23

Approved to treat moderate to severe plaque psoriasis in adults.

Its use for the treatment of psoriatic arthritis has been demonstrated.

A subcutaneous injection of 100 mg given every eight weeks, except for the second dose, which is given four weeks after the first dose.

It lowers the release of immune system signalling molecules, patients have a higher risk of getting infections from bacteria, viruses, and fungi.

Patients must be screened for tuberculosis infection prior to treatment.

Most common side effects are upper respiratory tract infections, headache, injection site reactions, joint pain, diarrhea, stomach flu, fungal skin infections and herpes simplex infections.

It only marginally increases the risk of having an adverse effects.

It targets the IL-23 subunit alpha (p19 subunit) hence preventing it from binding cell receptors that would otherwise be activated by its presence.

The list price of each 100 mg dose to be given once every two months is about $10,000.

Its safety and efficacy compared to a placebo and to adalimumab in the VOYAGE 1. and VOYAGE 2 phase 3 clinical trials: a significantly higher proportion of patients taking guselkumab had better skin clearance compared to adalimumab or placebo.

The phase 3 clinical trial NAVIGATE showed that patients who switched to guselkumab from ustekinumab did better than those who stuck to ustekinumab.


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