What is Tremfya (guselkumab)?

Reviewed by: HU Medical Review Board | Last updated: July 2022

Tremfya is a systemic medication used to treat adults with moderate to severe plaque psoriasis. Tremfya is the first biologic therapy approved by the U.S. Food and Drug Administration (FDA) that selectively blocks interleukin (IL)-23, a cytokine (chemical messenger) that is involved in the inflammatory process of the immune system.1,2

Biologics are drugs that have been genetically engineered to act on specific immunological targets. Unlike other immune therapies that have an overall, systemic suppressing effect on the immune system, biologics create far less interference with other biological functions.3

How does Tremfya work to treat plaque psoriasis?

In autoimmune diseases like psoriasis, the inflammatory response is abnormally activated, causing damage to tissues and creating the plaques on the skin. By blocking IL-23 from connecting to its receptor, Tremfya interrupts the abnormal inflammatory process and inhibits the release of the chemical messengers which increase inflammation.2

How is Tremfya administered?

Tremfya is delivered as an injection that is given subcutaneously (under the skin). At the beginning of treatment (week 0), one injection is given. Tremfya is administered again at week 4, and then every 8 weeks from then on. Tremfya comes in a single-dose prefilled syringe that contains 100 mg/mL of guselkumab, the active ingredient. Each prefilled syringe should be used only once, and the injection site should be rotated, choosing from the front of the thighs, the lower abdomen, or the back of the upper arms (if someone else is giving the injection).2 It is also now available in an autoinjector called One-Press.

Who can take Tremfya?

Tremfya is for use in treating adults with moderate to severe plaque psoriasis who may benefit from systemic therapy or phototherapy. Tremfya should only be used in adults, as it has not been tested for safety or effectiveness in children under 18 years of age.

Before beginning therapy with Tremfya, patients need to discuss their general
health and all medical conditions, including:

  • Any infections that do not go away or keep coming back
  • Tuberculosis (TB) or close contact with someone who has TB
  • Any recent or currently scheduled vaccines (immunizations)
  • Current or planned pregnancies
  • Breastfeeding

In addition, it is important for patients to discuss any medications, vitamins, or supplements they are currently using.2 Before starting Tremfya patients should have a negative tuberculosis (TB) screening.

What are the common side effects and risks of taking Tremfya?

While not an exhaustive list, the most common side effects experienced by patients taking Tremfya in clinical trials are upper respiratory infections, headache, pain or irritation at the site of the injection, joint pain, diarrhea, gastroenteritis (inflammation of the stomach and intestines that can cause diarrhea, vomiting, or pain), ear infections, and herpes simplex infections (like cold sores and genital herpes). Because Tremfya works by interrupting the inflammatory response of the immune system, it may increase the risk of infection.2

Can Tremfya be used with other treatments or drugs?

Tremfya should not be used at the same time as receiving any live vaccines. An exploratory study found that the potential for drug interactions for people using Tremfya who are also taking drugs metabolized by CYP2D6 cannot be ruled out, which may include some antidepressants or antifungal medications. These patients may need close monitoring and adjustment of their dose of Tremfya or other products.2

Talk to your doctor or pharmacist about any concerns with drug interactions.

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