Introduction

Guselkumab (trade name: Tremfya) has been approved in Germany since November 2017 for the systemic treatment of moderate to severe plaque psoriasis in adults.

Psoriasis is a non-contagious inflammatory skin disease. The symptoms usually include clearly defined red patches (called "plaques"), scaly skin and often itching too. They come and go in bouts: The skin can get better on its own, but it may also suddenly get worse. Psoriasis is a chronic (long-lasting) condition that currently has no cure.

It is usually treated with creams or ointments. Treatment with UV light (phototherapy) is an option for people with severe psoriasis. There are also medications designed to slow down or stop the inflammatory process in different ways. They can either be taken as tablets or injected into the bloodstream. Treatment with drugs that have an effect on the entire body is called systemic treatment.

Guselkumab is used in systemic treatment to decrease the inflammation in the skin by inhibiting a chemical messenger that is involved in inflammatory processes.

Application

Guselkumab is available in ready-to-use syringes at a dose of 100 mg.

After the first 100 mg injection, the same dose is given again four weeks later. Then injections are given every eight weeks. Patients can also inject themselves after being instructed how to do so by a doctor.

The success of the treatment needs to be assessed regularly. If there's no improvement after 16 weeks, stopping the treatment is recommended.

Other treatments

For people with moderate to severe plaque psoriasis who are able to have systemic treatment, the drugs fumaric acid ester, ciclosporin, methotrexate or secukinumab are available. Phototherapy is also an option.

For patients who have had other systemic treatments that didn’t work well enough or those who can’t have other systemic treatments, the drugs adalimumab, infliximab, ustekinumab or secukinumab are an option.

Assessment

In 2018, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) looked into whether guselkumab has any advantages or disadvantages when compared with the standard treatments for the following groups of people:

  • Adults with moderate to severe chronic plaque psoriasis who are able to have systemic treatment.
  • Adults with moderate to severe plaque psoriasis who weren't helped enough by a different systemic treatment or were unable to have it.

Learn more

More information

This information summarizes the main results of a review produced by the Institute for Quality and Efficiency in Health Care (IQWiG, Germany). The review was commissioned by the German Federal Joint Committee (G-BA) as part of the “early benefit assessment of medications.” On the basis of the review and the hearings received, the G-BA passed a resolution on the added benefit of guselkumab (Tremfya).