Guselkumab

Last updated

Guselkumab
Monoclonal antibody
Type Whole antibody
Source Human
Target IL23
Clinical data
Trade names Tremfya
AHFS/Drugs.com Monograph
MedlinePlus a617036
License data
Pregnancy
category
  • AU:B1
Routes of
administration
Subcutaneous
ATC code
Legal status
Legal status
Identifiers
CAS Number
DrugBank
ChemSpider
  • none
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]

Contents

Medical uses

Guselkumab is indicated to treat plaque psoriasis, psoriatic arthritis, and ulcerative colitis. [5]

Adverse effects

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]

Pharmacology

Mechanism of action

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]

Pharmacokinetics

History

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]

Society and culture

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]

Economics

The list price of each 100 mg dose is about US$10,000. [22]

Names

During development, guselkumab was referred to as CNTO-1959. [13]

Research

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]

References

  1. "Tremfya (Guselkumab) Australian Product Information". Department of Health, Therapeutic Goods Administration. The Australian Government.
  2. "Product information". health-products.canada.ca. 27 November 2017. Retrieved 18 March 2024.
  3. "Skin health". Health Canada . 9 May 2018. Retrieved 13 April 2024.
  4. "Tremfya 100 mg solution for injection in pre-filled pen - Summary of Product Characteristics (SmPC)". (emc). 1 November 2020. Retrieved 12 June 2021.
  5. 1 2 3 "Tremfya- guselkumab injection". DailyMed. Retrieved 22 January 2021.
  6. "European Medicines Agency". European Medicines Agency {EMA). 17 September 2018. Retrieved 12 June 2021.
  7. 1 2 "Guselkumab Injection". MedlinePlus Drug Information.
  8. "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.
  9. 1 2 "Tremfya (guselkumab) receives U.S. FDA approval for adults with moderately to severely active ulcerative colitis, strengthening Johnson & Johnson's leadership in inflammatory bowel disease" (Press release). Johnson & Johnson.
  10. Kim PJ, Lansang RP, Vender R (July 2023). "A Systematic Review and Meta-Analysis of Injection Site Reactions in Randomized-Controlled Trials of Biologic Injections". Journal of Cutaneous Medicine and Surgery. 27 (4): 358–367. doi:10.1177/12034754231188444. PMC   10486173 . PMID   37533141.
  11. "TREMFYA". Drug Approvals and Databases > Drug Trials Snapshots. U.S. Food and Drug Administration. 3 August 2017.
  12. 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): 715–725. doi: 10.1016/S1074-7613(00)00070-4 . PMID   11114383.{{cite journal}}: CS1 maint: overridden setting (link)
  13. 1 2 3 4 Markham A (September 2017). "Guselkumab: First Global Approval". Drugs. 77 (13): 1487–1492. doi:10.1007/s40265-017-0800-7. PMID   28819723. S2CID   35810454.
  14. 1 2 "Janssen Wins FDA Approval for Plaque Psoriasis Treatment Tremfya". Genetic Engineering & Biotechnology News. 14 July 2017.
  15. "Janssen Submits Application to EMA Seeking Approval of Anti-Interleukin-23 Monoclonal Antibody Guselkumab for the Treatment of Moderate-to-Severe Plaque Psoriasis" (Press release). Janssen. Archived from the original on 7 November 2017. Retrieved 1 November 2017.
  16. "Novel Drug Approvals for 2017". U.S. Food and Drug Administration (FDA). 25 January 2021.
  17. "Regulatory Decision Summary for Tremfya". Drug and Health Products Portal. 10 November 2017. Retrieved 18 March 2024.
  18. "Regulatory Decision Summary for Tremfya". Drug and Health Products Portal. 4 September 2020. Retrieved 18 March 2024.
  19. "MorphoSys' licensee Janssen receives Japanese approval for Tremfya to treat moderate to severe forms of psoriasis & psoriatic arthritis". pharmabiz.com. Archived from the original on 29 April 2021. Retrieved 5 June 2018.
  20. "FDA approves Tremfya (guselkumab) for psoriatic arthritis". www.mdedge.com. Retrieved 15 July 2020.
  21. "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.
  22. 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.
  23. 1 2 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.{{cite journal}}: CS1 maint: overridden setting (link)