Tremfya
Tremfya (guselkumab) is an under-the-skin injection that's approved for both moderate-to-severe plaque psoriasis and active psoriatic arthritis. It's commonly used for psoriasis if oral and topical medications haven't helped control your symptoms.
What is Tremfya (guselkumab)?
What is Tremfya (guselkumab) used for?
Moderate-to-severe plaque psoriasis, in people who might benefit from systemic therapy (e.g., pills or injections) or treatment using ultraviolet (UV) light
Active psoriatic arthritis
How Tremfya (guselkumab) works
Tremfya (guselkumab) is a monoclonal antibody. It blocks a protein called interleukin-23 (IL-23) in your body, which normally activates your immune system. By blocking IL-23, Tremfya (guselkumab) lowers inflammation (swelling) in your body to treat symptoms of plaque psoriasis and psoriatic arthritis.
Drug Facts
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What are the side effects of Tremfya (guselkumab)?
Common Side Effects
- Upper respiratory infection (e.g., sore throat, common cold; 14%)
- Headache (5%)
- Injection site reactions (e.g., redness, swelling, itching; 5%)
- Joint pain (3%)
Other Side Effects
- Diarrhea
- Stomach flu
- Fungal infection
- Herpes infection
- Migraine
- Hives
Serious Side Effects
- Severe allergic reactions: skin rash, hives, itching, swelling of face or tongue, trouble breathing, chest tightness
- Infections: fever, trouble breathing, cough that won't go away, night sweats, confusion, feeling very tired, diarrhea, chills, muscle aches
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Infection—fever, chills, cough, sore throat, wounds that don't heal, pain or trouble when passing urine, general feeling of discomfort or being unwell
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Diarrhea
- Headache
- Joint pain
- Pain, redness, or irritation at injection site
- Runny or stuffy nose
- Sore throat
Pros and cons of Tremfya (guselkumab)
Pros
Can inject yourself at home after proper training
Injection needle is hidden if using the patient-controlled injector, so you don't see it (unless you look for it)
Certain insurance plans offer some cost coverage
Injected once every 8 weeks (after the first two starter doses)
Cons
Raises the risk of infections
Can cause some injection site reactions
Can take several months to see the benefits of the medication
Only available as a brand-name medication, so it can be very expensive
Pharmacist tips for Tremfya (guselkumab)
Tremfya (guselkumab) is available as either a pre-filled syringe or a patient-controlled injector. Regardless of which one you use, you should receive your first dose at the provider's office. This is so they can coach and watch to make sure you inject yourself correctly. If you need a refresher, check out the Instructions for Use or watch these helpful videos. If you have any questions about how to use Tremfya (guselkumab), ask your healthcare provider or pharmacist.
Before using Tremfya (guselkumab), check the expiration date and look at the liquid in the viewing window. It should be clear to slightly yellow, and might have tiny white or clear particles or air bubbles. This is normal. Don't use it if it looks cloudy, discolored, or has large particles inside. Otherwise, the medication could be unsafe for you to use. You'll need to call your provider or pharmacist for a refill.
Wash your hands with soap and warm water before you inject Tremfya (guselkumab). Also, clean the area of skin where you're going to inject the medication with an alcohol swab and allow it to air dry. Remove the needle cover and inject the medication within 5 minutes.
Inject Tremfya (guselkumab) into the fatty part of the skin either on top of your thigh, belly area, or back of your upper arm if someone else is helping you inject. If you're injecting into the belly area, stay 2 inches away from your belly button. Don't inject into areas of the skin that are tender, red, hard, bruised, scaly, or affected by psoriasis.
If you need to, you can cover the injection site with a bandage. Avoid rubbing it, since this can change the way Tremfya (guselkumab) is absorbed in your body.
Put your Tremfya (guselkumab) pre-filled syringe or patient-controlled injector in a sharps container right after using it. Don't throw it away in your household trash to lower the risk of needlestick injuries.
Keep Tremfya (guselkumab) protected from light and in the refrigerator when you're not using it. Before you inject yourself, let the syringe sit out for about 30 minutes and get to room temperature. Don't try to warm it up with your hands or any other way because it might damage the medication.
Frequently asked questions about Tremfya (guselkumab)
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What are the risks and warnings for Tremfya (guselkumab)?
Tremfya (guselkumab) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Severe allergic reactions
Some people reported having severe allergic reactions after using Tremfya (guselkumab). If you experience trouble breathing, swelling in your face or mouth, skin rash, hives, or itching after using Tremfya (guselkumab), get medical help right away.
Infections
Risk factors: Active, long-term, or frequent infection | Conditions that can raise your risk for infection | Taking other medications that can weaken your immune system
Tremfya (guselkumab) can raise your risk of infections. Practice good hand hygiene and avoid close contact with those who are sick. If you develop any symptoms of an infection, such as fever, trouble breathing, a cough that won't go away, night sweats, or confusion, contact your provider immediately. You might need to stop taking Tremfya (guselkumab) for some time until after you recover from the infection. Don't take the medication if you have an active infection.
Make sure your provider knows your medical history before starting Tremfya (guselkumab), especially if you've ever had tuberculosis (TB). Watch for signs and symptoms of active TB such as cough, fever, or night sweats during and after Tremfya (guselkumab) treatment. You'll need to get tested for TB before starting and during treatment with the medication. If you have a history of TB infection, you'll likely get treated for TB before starting or continuing Tremfya (guselkumab).
Vaccines
To help avoid getting sick, your provider will make sure that you're up to date with your vaccines. Once you start treatment with Tremfya (guselkumab), you won't be able to get live vaccines like MMR (measles, mumps, and rubella vaccine) or Varivax (chickenpox vaccine). Before getting any vaccines while taking this medication, ask your provider or pharmacist to make sure they're safe for you to get.
Tremfya (guselkumab) dosage forms
Typical dosing for Tremfya (guselkumab)
The typical dose is the same for treating plaque psoriasis and psoriatic arthritis. You'll start out with one injection at week 0 and one injection at week 4. Then, you'll receive an injection every 8 weeks.
Week 0 (first day of treatment): Inject 100 mg under the skin once.
Week 4: Inject 100 mg under the skin once.
Week 12 and every 8 weeks afterward: Inject 100 mg under the skin once.
How much does Tremfya (guselkumab) cost?
What are alternatives to Tremfya (guselkumab)?
Moderate-to-severe plaque psoriasis, in people who might benefit from systemic therapy (e.g., pills or injections) or treatment using ultraviolet (UV) light
Active psoriatic arthritis
Moderate-to-severe plaque psoriasis
Psoriatic arthritis
Moderate-to-severe Crohn's disease
Moderate-to-severe plaque psoriasis (Ps) in adults and children ages 6 years and older
Psoriatic arthritis (PsA) in adults and children ages 6 years and older
Moderate-to-severe Crohn's disease (CD) in adults
Moderate-to-severe ulcerative colitis (UC) in adults
What is the latest news about Tremfya (guselkumab)?
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