Current Edition

NICE recommends Janssen’s treatment for active psoriatic arthritis

Clinical trial evidence suggests that Tremfya is effective when compared with a placebo.

Tremfya – also known as guselkumab – has been recommended by the National Institute for Health and Care Excellence (NICE) for people with active psoriatic arthritis whose disease does not respond to conventional disease-modifying anti-rheumatic drugs (DMARDs).

The group involves individuals who have had at least one biological DMARD or whose tumour necrosis factor inhibitors are contraindicated. The treatment, which has been developed by Janssen, can be taken alone or in combination with methotrexate.

Guselkumab is a biological DMARD and a monoclonal antibody that works by blocking the activity of a protein that presents at increased levels in people with psoriasis and psoriatic arthritis.

Clinical trial evidence suggests that Tremfya is effective when compared with a placebo. While there were no direct comparisons with other biological DMARDs for treating psoriatic arthritis, indirect comparisons suggest that the therapy is as effective – particularly for symptoms affecting the skin.

The recommended dose of Tremfya is 100mg, delivered by injection under the skin. After the first dose, a further dose is required after four weeks and then every eight weeks. It can also be administered at home.

The response to the treatment is typically assessed from 16 weeks and stopped at 24 weeks if psoriatic arthritis has not responded adequately.

Psoriatic arthritis is a type of arthritis that affects some people with the skin condition psoriasis. It often causes affected joints to become swollen, stiff and painful. Like psoriasis, psoriatic arthritis is a long-term condition that can get progressively worse. Active psoriatic arthritis is peripheral arthritis with three or more tender joints and three or more swollen joints.

Janssen has a commercial arrangement with the NHS which makes Tremfya available with a discount. The company estimates there are around 16,000 people who would be eligible for the treatment.