By Gary M. White, MD
Note, this is a brief summary only and is meant to emphasize dermatologic aspects. More complete information, including the package insert and recent studies should be consulted before prescribing.
Guselkumab is an interleukin-23 inhibitor FDA-approved for the treatment of psoriasis. Results show it to be highly effective. For example, in one study at 16 weeks, 91% of patients achieved a PASI 75% response.
- Guselkumab is a human monoclonal antibody directed at the p-19 subunint of interleukin-23.
- In head to head studies, guselkumab is more efficacious than adalimumab [JAAD 2017;76;405].
TREMFYA is an interleukin-23 blocker indicated for the treatment of adult patients with moderate-to-severe plaque psoriasis who are candidates for systemic therapy or phototherapy.
Guselkumab 100 mg is given by subcutaneous injection at weeks 0, 4 and then every 8 weeks.
In one study, the rate of infections treated with antibiotics was lower than placebo. Injection-site reactions occur in a small percentage of patients.
From the package insert: Most common (≥1%) adverse reactions associated with TREMFYA include upper respiratory infections, headache, injection site reactions, arthralgia, diarrhea, gastroenteritis, tinea infections, and herpes simplex infections.
- Infections: TREMFYA may increase the risk of infection. Instruct patients to seek medical advice if signs or symptoms of clinically important chronic or acute infection occur. If a serious infection
develops, discontinue TREMFYA until the infection resolves.
- Tuberculosis (TB): Evaluate for TB prior to initiating treatment withTREMFYA
Avoid use of live vaccines in patients treated with TREMFYA.
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