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14 June 2018

Tremfya (Guselkumab) - New Biologic Approved for Psoriasis in England & Wales

NICE gives a positive opinion on Tremfya (Guselkumab) for the treatment of severe psoriasis in England and Wales.

The National Institute for Health and Care Excellence (NICE) has today published its decision to recommend the biologic medication Tremfya (also known by its generic name, Guselkumab) as a treatment option for adults with plaque psoriasis in England and Wales in the following circumstances:

  • The person's psoriasis is severe, as defined by a total Psoriasis Area and Severity Index (PASI) of 10 or more and a Dermatology Life Quality Index (DLQI) of more than 10, and;
  • The person's psoriasis has not responded to other systemic treatments, including ciclosporin, methotrexate and PUVA, or where these treatments cannot be tolerated by the patient.

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, the immune system is overactive and creates too much inflammation, which leads to the development of psoriasis symptoms. By blocking IL-23, Tremfya aims to prevent some of that inflammation from occurring, leading to an improvement in psoriasis symptoms for some people who take it.

There is currently one other biologic medication that blocks the activity of IL-23 available for people with severe psoriasis, 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 Dermatology Nurses, 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. Tremfya can be prescribed on its own, or alongside methotrexate.

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