Does Tremfya Carry Warnings for Active Infections?
Tremfya (guselkumab), an IL-23 inhibitor for plaque psoriasis, psoriatic arthritis, and ulcerative colitis, has specific warnings against use in patients with active infections. The prescribing information states it may increase infection risk by suppressing immune responses, and treatment should not start during active infections.[1] Clinical trials showed higher serious infection rates (1.4 per 100 patient-years) versus placebo (0.7 per 100 patient-years), including tuberculosis reactivation.[1]
What Infections Are Patients Most Concerned About?
Common infections linked to Tremfya include upper respiratory tract infections (14-19% incidence), herpes infections, and fungal issues like tinea pedis. Serious cases involved cellulitis, pneumonia, and diverticulitis. Prescribers must screen for latent tuberculosis and hepatitis B before starting, as reactivation occurred in trials.[1] Avoid live vaccines during treatment and for 12 weeks after the last dose.[1]
How Do Doctors Handle Active Infections Before Starting?
Guidelines recommend delaying Tremfya until infections resolve. Monitor closely post-initiation; discontinue if serious infection develops. For mild cases like colds, decisions weigh risks, but active serious infections (e.g., pneumonia) typically pause therapy.[1] No head-to-head data exists on resuming after resolution.
How Does Tremfya's Infection Risk Compare to Other Biologics?
Tremfya shows lower serious infection rates than TNF inhibitors like Humira (4.3 per 100 patient-years) or Stelara (IL-12/23 inhibitor, similar profile).[2] In psoriasis trials, it matched or beat placebo in some infection types, but real-world data flags caution for immunocompromised patients.[1][2]
Can Patients with Chronic or Recurrent Infections Use It?
Chronic infections (e.g., controlled HIV or stable hepatitis C) may allow use after specialist review, but active flares bar initiation. Trial exclusions included active TB or serious infections within 3 months prior.[1] Patient reports on forums note flares post-treatment, though causality is unclear.
[1] Tremfya Prescribing Information (Janssen, 2023)
[2] DrugPatentWatch.com - Guselkumab Safety Profile