Tremfya (Guselkumab) - New biologic treatment approved for psoriatic arthritis in Scotland

The injectable treatment gets approval from the SMC for psoriatic arthritis in Scotland.

The Scottish Medicines Consortium (SMC) has today published its decision to recommend the biologic medicine, Tremfya (also known by its generic name, Guselkumab), for the treatment of psoriatic arthritis in Scotland. This brings Scotland in line with England and Wales where the National Institute for Health and Care Excellence (NICE) approved Tremfya for the treatment of psoriatic arthritis in May 2021.

The SMC guidance states that Tremfya, either alone or in combination with methotrexate, is recommended as an option for treating active psoriatic arthritis in adults in the following circumstances:

• When the individual's psoriatic arthritis has not responded adequately to two previous conventional disease-modifying antirheumatic drugs (DMARDs) or they cannot tolerate these treatments, and they have not yet received a biologic medication (biologic-naïve population);
• When the individual's psoriatic arthritis has not responded adequately to conventional DMARDs and one or more biologic medications from the tumour necrosis factor (TNF) inhibitor class, such as Adalimumab, Cimzia, Etanercept, Infliximab or Simponi, (biologic-experienced population);
• When the individual cannot take or tolerate biologic medications from the tumour necrosis factor (TNF) inhibitor class.


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.