Common Side Effects of Tremfya
Tremfya (guselkumab), an IL-23 inhibitor for plaque psoriasis, psoriatic arthritis, and ulcerative colitis, most often causes upper respiratory infections like colds or sinus issues, affecting about 15-20% of users in clinical trials. Other frequent reactions include headache (around 10%), joint pain, diarrhea, fatigue, and injection-site reactions such as redness, itching, or pain.[1][2]
Serious Side Effects and Risks
Serious risks include infections like tuberculosis or fungal infections, due to immune suppression—patients need screening beforehand. Hypersensitivity reactions, including anaphylaxis, can occur. There's increased risk of malignancies, though data shows no clear causal link. For ulcerative colitis users, watch for worsening colitis or perforation. Liver enzyme elevations happen in some cases.[1][2][3]
Side Effects in Specific Conditions
In psoriasis trials, infections topped the list at 14% vs. 9% placebo, with bronchitis common. Psoriatic arthritis data mirrors this, adding fatigue and nausea. Ulcerative colitis studies report similar infection rates (22% vs. 20% placebo), plus abdominal pain and worsening disease in 1-3%.[2][3]
What Happens If You Get an Infection on Tremfya?
Stop treatment and seek care for active infections. Avoid live vaccines during therapy. Pre-treatment TB tests are required; report fever, cough, or weight loss promptly.[1]
How Do Tremfya Side Effects Compare to Stelara or Skyrizi?
Tremfya has fewer GI issues than Stelara (ustekinumab) but similar infection rates. Skyrizi (risankizumab) shows comparable profiles, with slightly lower headache incidence but higher nasopharyngitis.[2][4]
Long-Term Side Effects and Monitoring
Over 5 years in extensions, infection rates stay stable without new signals, but ongoing cancer and infection monitoring is advised. Liver tests recommended for at-risk patients.[3]
[1]: Tremfya Prescribing Information (Janssen)
[2]: FDA Label for Guselkumab
[3]: ClinicalTrials.gov Summaries (NCT02207231, NCT02207244)
[4]: Drugs.com Comparison Tool