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Monoclonal antibody against interleukins

Guselkumab, sold under the brand name Tremfya, is a monoclonal antibody against interleukin-23 used for the treatment of plaque psoriasis.[5][6]

Medical uses

Guselkumab is indicated to treat moderate to severe plaque psoriasis, and psoriatic arthritis in adults.[3]Guselkumab is provided as a subcutaneous injection of 100 mg given every eight weeks (except for the second dose, which is given four weeks after the first dose).[7]

Adverse effects

Because guselkumab lowers the release of immune system signalling molecules, patients may have a higher risk of getting infections from bacteria, viruses, and fungi.[5] For this reason, people with psoriasis being considered for treatment with guselkumab must be screened for tuberculosis infection prior to treatment with guselkumab.[5]The most common side effects for guselkumab are upper respiratory tract infections, headache, injection site reactions, joint pain, diarrhea, gastroenteritis, fungal skin infections and herpes simplex infections.[8] Because guselkumab is a new medicine, the long-term effects are not fully understood.[9]

Pharmacology

Mechanism of action[edit]

Guselkumab targets the IL-23 subunit alpha (p19 subunit)[10] preventing it from binding to cell receptors that would otherwise be activated by its presence.[11]

Pharmacokinetics[edit]

  • Cmax 8.09 µg/mL
  • tmax 5.5 days
  • volume of distribution 13.5 L
  • apparent clearance 0.516 L/day[11]

Commercialization[edit]

Guselkumab was developed by Janssen Global Services, LLC.[12] In November 2016, Janssen submitted a Biologics License Application (BLA) to the FDA seeking approval of guselkumab.[13]In July 2017, Janssen gained US FDA approval to market guselkumab for treatment of plaque psoriasis.[14]In April 2018, Guselkumab was approved in Japan for the treatment psoriatic arthritis.[15]In July 2020, the FDA approved as the first IL-23 inhibitor to treat active psoriatic arthritis (PsA) in the USA. [16][17]Guselkumab is manufactured by Janssen Sciences Ireland UC in Cork, Ireland.[18]

Cost[edit]

The list price of each 100 mg dose (to be given once every two months) is about $10,000.[19]

Research and development[edit]

During development, guselkumab was referred to as CNTO-1959.[11] Guselkumab has undergone phase 3 clinical trials comparing it with adalimumab (Humira) and ustekinumab (Stelara).[12]The safety and efficacy of guselkumab was compared to a placebo and to adalimumab in the “VOYAGE 1” and “VOYAGE 2” phase 3 clinical trials (ClinicalTrials.gov IDs: NCT02207231 and NCT02207244).[9] Preliminary results indicated that a significantly higher proportion of patients taking guselkumab had better skin clearance compared to those taking the other treatments. At week 16, 73.3% of patients taking guselkumab achieved a PASI 90 (90% reduction in PASI score from baseline), vs 49.7% of those taking adalimumab; additionally, 91.2% of patients taking guselkumab achieved a PASI 75 (75% reduction in PASI score from baseline), vs 73.1% of those taking adalimumab.[9]The phase III clinical trial “NAVIGATE” (ClinicalTrials.gov ID: NCT02203032) included only patients who had poor responses to treatment with ustekinumab. It showed that patients who switched to guselkumab from ustekinumab did better than those who remained on ustekinumab.[11]

References[edit]

  1. ^ “Tremfya (Guselkumab) Australian Product Information”. Department of Health, Therapeutic Goods Administration. The Australian Government.
  2. ^ “Tremfya 100 mg solution for injection in pre-filled pen – Summary of Product Characteristics (SmPC)”. (emc). 1 November 2020. Retrieved 12 June 2021.
  3. ^ Jump up to:a b “Tremfya- guselkumab injection”. DailyMed. Retrieved 22 January 2021.
  4. ^ “European Medicines Agency”. European Medicines Agency {EMA). Retrieved 12 June 2021.
  5. ^ Jump up to:a b c “Guselkumab Injection”. MedlinePlus Drug Information.
  6. ^ “Guselkumab”. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. National Institute of Diabetes and Digestive and Kidney Diseases. June 2018. PMID 31643594.
  7. ^ “Janssen Announces U.S. FDA Approval of Tremfya (Guselkumab) for the Treatment of Moderate to Severe Plaque Psoriasis”. Johnson & Johnson. 13 July 2017.
  8. ^ “TREMFYA”. Drug Approvals and Databases > Drug Trials Snapshots. U.S. Food and Drug Administration. 3 August 2017.
  9. ^ Jump up to:a b c Nakamura M, Lee K, Jeon C, Sekhon S, Afifi L, Yan D, et al. (September 2017). “Guselkumab for the Treatment of Psoriasis: A Review of Phase III Trials”. Dermatology and Therapy. 7 (3): 281–292. doi:10.1007/s13555-017-0187-0. PMC 5574739. PMID 28639011.
  10. ^ Oppmann B, Lesley R, Blom B, Timans JC, Xu Y, Hunte B, et al. (November 2000). “Novel p19 protein engages IL-12p40 to form a cytokine, IL-23, with biological activities similar as well as distinct from IL-12”. Immunity. 13 (5): 715–25. doi:10.1016/S1074-7613(00)00070-4. PMID 11114383.
  11. ^ Jump up to:a b c d Markham A (September 2017). “Guselkumab: First Global Approval”. Drugs. 77 (13): 1487–1492. doi:10.1007/s40265-017-0800-7. PMID 28819723. S2CID 35810454.
  12. ^ Jump up to:a b “Janssen Wins FDA Approval for Plaque Psoriasis Treatment Tremfya”. Genetic Engineering & Biotechnology News. 14 July 2017.
  13. ^ “Janssen Submits Application to EMA Seeking Approval of Anti-Interleukin-23 Monoclonal Antibody Guselkumab for the Treament of Moderate-to-Severe Plaque Psoriasis”. Janssen.
  14. ^ “Novel Drug Approvals for 2017”. U.S. Food and Drug Administration. 25 January 2021.
  15. ^ “MorphoSys’ licensee Janssen receives Japanese approval for Tremfya to treat moderate to severe forms of psoriasis & psoriatic arthritis”. pharmabiz.com. Retrieved 5 June 2018.
  16. ^ “FDA approves Tremfya (guselkumab) for psoriatic arthritis”. http://www.mdedge.com. Retrieved 15 July 2020.
  17. ^ “DGAP-News: MororphoSys’s Licensee Janssen Announces Approval of Tremfya (Guselkumab) by U.S. FDA for Treatment of Adults with Active Psoriatic Arthritis”. Bloomberg.com. 14 July 2020. Retrieved 6 September 2020.
  18. ^ “Guselkumab BLA Approval Letter” (PDF). U.S. Food and Drug Administration.
  19. ^ Helfand C (13 July 2017). “Johnson & Johnson’s Tremfya gets its go-ahead to fight Novartis, Lilly in psoriasis. Can it stand out?”. Fierce Pharma.

External links[edit]

  • “Guselkumab”. Drug Information Portal. U.S. National Library of Medicine.

Categories: Health, Medicine

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