Guselkumab (Tremfya) for the treatment of plaque psoriasis in adults who are able to have systemic treatment
In 2018, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) assessed the advantages and disadvantages of guselkumab (trade name: Tremfya) compared with the standard treatment for people with moderate to severe plaque psoriasis who are able to have systemic treatment. For the purpose of this comparison, the manufacturer provided data from 119 patients. Of these, 60 people had treatment with guselkumab, while 59 had the standard treatment with fumaric acid esters. The participants hadn’t had systemic treatment for at least 6 months before the study. They were treated for about 6 months as part of the study.
What are the advantages of guselkumab?
- Complete remission of psoriasis: The study suggests that guselkumab has an advantage here when compared with the standard treatment. After about 6 months, the skin inflammation had gone away at least temporarily in 50 out of 100 people who had treatment with guselkumab. This was the case in about 15 out of 100 people who had treatment with fumaric acid esters.
- Health-related quality of life: According to initial analyses, the study suggests that guselkumab has an advantage here. After about 4 months, half the people who had treatment with guselkumab reported that the disease no longer affected their quality of life. This took almost 6 months in the group that had treatment with fumaric acid esters.
- Treatment stopped due to side effects: The study suggests that guselkumab has an advantage here too: In this group, nobody stopped treatment due to side effects, while almost 28 out of 100 people who had treatment with fumaric acid esters did.
- According to early analyses, guselkumab seems to have an advantage in terms of gastrointestinal problems, too. This side effect occurred in almost 22 out of 100 people who had treatment with guselkumab, compared to 81 out of 100 people who had treatment with fumaric acid esters.
- Feeling hot: The study suggests that guselkumab has an advantage here, too: This side effect occurred in nobody in this group, but in 31 out of 100 people who had treatment with fumaric acid esters.
What are the disadvantages of guselkumab?
- Guselkumab wasn’t found to have any disadvantages compared to fumaric acid esters.
- There was no difference between the treatments in terms of severe side effects or infections and parasitic diseases.
What remains unanswered?
- Symptoms: The manufacturer didn't provide data on patients’ self-reported symptoms, or on psoriasis on the scalp.
Institute for Quality and Efficiency in Health Care (IQWiG, Germany). Guselkumab (plaque psoriasis) – Benefit assessment according to §35a Social Code Book V. Dossier assessment; Commission A17-60. February 27, 2018. (IQWiG reports; Volume 599).
IQWiG health information is written with the aim of helping
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