Tremfya (Guselkumab) - NICE Approves New Biologic Treatment for Psoriatic Arthritis

The injectable treatment gets approval for psoriatic arthritis in England and Wales.

The National Institute for Health and Care Excellence (NICE) has today published its decision to recommend Tremfya (also known by its generic name, Guselkumab), for the treatment of psoriatic arthritis in adults in England and Wales.

The guidance states that Tremfya, alone or with methotrexate, is recommended as an option for treating active psoriatic arthritis in adults whose condition has not responded well enough to disease-modifying antirheumatic drugs (DMARDs) or who cannot tolerate these treatments, if the individual has:

• Peripheral arthritis with 3 or more tender joints and 3 or more swollen joints
• Moderate to severe psoriasis (a body surface area of at least 3% affected by plaque psoriasis and a Psoriasis Area and Severity Index [PASI] score greater than 10)
• Already had 2 conventional DMARDs and at least 1 biological DMARD


How does Tremfya work?

Tremfya blocks the activity of interleukin 23 (IL-23), a chemical ’messenger’ in the immune system that signals other cells to cause inflammation. In people with psoriasis or psoriatic arthritis, the immune system is overactive and creates too much inflammation, which leads to the development of psoriasis and/or psoriatic arthritis symptoms. By blocking IL-23, Tremfya aims to prevent some of that inflammation from occurring, leading to an improvement in psoriasis and psoriatic arthritis for some people who take it.

There is currently one other biologic medication that blocks the activity of IL-23 available for people with psoriatic arthritis, called Stelara (Ustekinumab).

How is Tremfya used?

Individuals take Tremfya at home by giving themselves an injection under the skin via a pre-filled syringe. Most people will be trained by a nurse to give the injection to themselves. The second dose is taken four weeks after the first, but after that Tremfya is usually taken every eight weeks.

People taking Tremfya will have regular blood tests every three to six months - usually carried out by Rheumatology Nurses, or by their own GP - to monitor for infections or other possible effects of the treatment. People taking Tremfya are more at risk of infections and so should be vaccinated against pneumonia and have an annual flu vaccination. However, not all vaccinations are safe in people taking Tremfya; ‘live’ vaccinations should be avoided. Check with a doctor or nurse before having any vaccinations or taking other medication if you are not sure.

For more information about Tremfya, have a read of our information sheet.