Guselkumab (Tremfya)


Guselkumab is a biologic medication used to treat adult patients with moderate-to-severe plaque psoriasis who are candidates for systemic therapy or phototherapy. The medication is an antibody that blocks interleukin (IL) 23. IL-23 is thought to play a role in psoriasis and psoriatic arthritis.

How to Take It

Guselkumab is given as an injection under the skin. The medicine can be injected into the thigh or abdomen. The site of injection should be rotated so the same area is not injected multiple times. Guselkumab comes in pre-filled syringes. There is only one dose, 100 mg given as an injection at week 0, week 4 and then every 8 weeks thereafter. Some patients will start to have improvement within a few weeks, but it may take several months to take full effect.

Side Effects

Guselkumab may lower your immune system and the ability to fight infections. Before starting guselkumab all patients should be tested for tuberculosis. Sinus infections, stomach infections, fungal infections, and herpes simplex infections occurred more frequently individuals who are taking the medication.

Before starting this medication talk with your rheumatology care team about getting tested for tuberculosis. In general, patients who may become pregnant should use effective contraception while using this medication. Guselkumab has not been studied in pregnancy and breastfeeding. If you forget to take a dose, take it as soon as you remember, then take the next dose at the appropriate scheduled time. It is advisable to take the first self-injection under the guidance of a healthcare professional for proper training and monitoring for an allergic reaction.

Tell Your Rheumatology Healthcare Team

If you develop signs of an infection or have any side effects, especially fever, or allergic reactions, you should stop taking the medication and contact your rheumatology healthcare team. If you are pregnant, planning to get pregnant, or are breastfeeding, let your team know before starting this medication. Guselkumab has not been studied in pregnancy or breastfeeding. If you are planning to have surgery or get any live vaccinations (nasal spray flu vaccine, measles, mumps, rubella, and yellow fever vaccines) talk to your rheumatology healthcare team first.

Written March 2024 by Elena Schiopu, MD, and reviewed by the American College of Rheumatology Communications and Marketing Committee.

This information is provided for general education only. Individuals should consult a qualified health care provider for professional medical advice, diagnosis, and treatment of a medical or health condition.

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