Monoclonal antibody | |
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Type | Whole antibody |
Source | Human |
Target | IL23 |
Clinical data | |
Trade names | Tremfya |
AHFS/Drugs.com | Monograph |
MedlinePlus | a617036 |
License data |
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Pregnancy category |
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Routes of administration | Subcutaneous |
ATC code | |
Legal status | |
Legal status | |
Identifiers | |
CAS Number | |
DrugBank | |
ChemSpider |
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UNII | |
KEGG | |
Chemical and physical data | |
Formula | C6402H9864N1676O1994S42 |
Molar mass | 143561.59 g·mol−1 |
Guselkumab, sold under the brand name Tremfya, is a monoclonal antibody against interleukin-23 used for the treatment of plaque psoriasis, psoriatic arthritis, and ulcerative colitis. [5] [7] [8] [9]
Guselkumab is indicated to treat plaque psoriasis, psoriatic arthritis, and ulcerative colitis. [5]
Guselkumab lowers the release of immune system signalling molecules, increasing the risk of infections from bacteria, viruses, and fungi. [7]
The most common side effects for guselkumab are upper respiratory tract infections, headache, injection site reactions, [10] joint pain, diarrhea, gastroenteritis, fungal skin infections and herpes simplex infections. [11]
Guselkumab targets the IL-23 subunit alpha (p19 subunit) [12] preventing it from binding to cell receptors that would otherwise be activated by its presence. [13]
Guselkumab was developed by Janssen Pharmaceuticals. [14] In November 2016, Janssen submitted a Biologics License Application (BLA) to the FDA seeking approval of guselkumab. [15]
In July 2017, the US Food and Drug Administration (FDA) approved guselkumab for the treatment of plaque psoriasis. [16]
In November 2017, Health Canada approved guselkumab for the treatment of plaque psoriasis. [17] In September 2020, the approval was expanded to include the treatment of adults with psoriatic arthritis. [18]
In April 2018, guselkumab was approved in Japan for the treatment of psoriatic arthritis. [19]
In July 2020, the FDA approved guselkumab as the first IL-23 inhibitor to treat active psoriatic arthritis (PsA). [20] [21]
In September 2024, the FDA approved guselkumab for the treatment of moderately to severely active ulcerative colitis in adults. [9]
The list price of each 100 mg dose is about US$10,000. [22]
During development, guselkumab was referred to as CNTO-1959. [13]
Guselkumab has undergone phase 3 clinical trials comparing it with adalimumab (Humira) and ustekinumab (Stelara). [14]
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). [23] 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. [23]
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. [13]
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