Guselkumab

Guselkumab Brand Name– Tremfya

What is Guselkumab

Guselkumab is a subcutaneously administered interleukin 23 (IL-23) blocker approved for the treatment of adults with moderate-to-severe plaque psoriasis who are candidates for systemic therapy or phototherapy and is also approved for treating psoriatic arthritis (PsA).

Compared to placebo, biologic drugs like guselkumab are able to achieve at least a 90% reduction from baseline in the PASI composite score (PASI 90) for induction therapy in patients with moderate to severe plaque psoriasis, and are more effective than traditional standard treatments.

The ideal therapy for individual patients with plaque psoriasis is determined by treat to target strategies and severity of disease, including the presence or absence of psoriatic arthritis; guselkumab was not specifically evaluated regarding its place in PsA treatment due to ongoing investigation of this agent at the time of publication.

As with other biologics that target interleukins, the drug may increase the risk for infections; all potential drug recipients should be evaluated for active or latent tuberculosis infection prior to initiating therapy

Indications

  • psoriasis
  • psoriatic arthritis

For the treatment of moderate to severe plaque psoriasis in those patients who are candidates for phototherapy or systemic therapy

Side Effects

  1. antibody formation
  2. arthralgia
  3. bleeding
  4. candidiasis
  5. diarrhea
  6. edema
  7. elevated hepatic enzymes
  8. erythema
  9. headache
  10. hematoma
  11. infection
  12. injection site reaction
  13. migraine
  14. pharyngitis
  15. pruritus
  16. rash
  17. serious hypersensitivity reactions or anaphylaxis
  18. skin discoloration
  19. urticaria

Monitoring Parameters

  • hepatitis B serology
  • plasma hepatitis C RNA
  • plasma HIV RNA
  • tuberculin skin test

Contraindications

  • breast-feeding
  • children
  • fungal infection
  • hepatitis
  • hepatitis C infection
  • HIV serum status
  • infants
  • infection
  • neonates
  • pregnancy
  • serious hypersensitivity reactions or anaphylaxis
  • surgery
  • tuberculosis
  • vaccination
  • viral infection

Interactions

  • Amitriptyline
  • Amitriptyline; Chlordiazepoxide
  • Amoxapine
  • Bacillus Calmette-Guerin Vaccine, BCG
  • Canakinumab
  • Clomipramine
  • Desipramine
  • Doxepin
  • Imipramine
  • Influenza Virus Vaccine
  • Intranasal Influenza Vaccine
  • Live Vaccines
  • Maprotiline
  • Measles Virus; Mumps Virus; Rubella Virus; Varicella Virus Vaccine, Live
  • Measles/Mumps/Rubella Vaccines, MMR
  • Methadone
  • Nortriptyline
  • Perphenazine; Amitriptyline
  • Pimozide
  • Protriptyline
  • Rotavirus Vaccine
  • Rubella Virus Vaccine Live
  • Smallpox and Monkeypox Vaccine, Live, Nonreplicating
  • Smallpox Vaccine, Vaccinia Vaccine
  • Thioridazine
  • Tricyclic antidepressants
  • Trimipramine
  • Typhoid Vaccine
  • Upadacitinib
  • Varicella-Zoster Virus Vaccine, Live
  • Yellow Fever Vaccine, Live