Tremfya provides another subsidised treatment option for PsA patients with inadequate response or intolerance to prior DMARD therapy.
Tremfya provides another subsidised treatment option for PsA patients with inadequate response or intolerance to prior DMARD therapy.
Selective IL-23 inhibitor guselkumab (Tremfya, Janssen) is now PBS listed for psoriatic arthritis, having been approved by the TGA for PsA treatment in January 2021. It was already listed on the PBS for moderate-to-severe plaque psoriasis.
The drug is indicated for the treatment of adult patients with active psoriatic arthritis who have had an inadequate response to, or are intolerant to, prior DMARD therapy.
“In people with active PsA, IL-23 becomes overactive, sending out continual signals that drive inflammation disrupting the natural balance within both joints and skin,” said rheumatology professor Peter Nash in a Janssen press release.
“Tremfya selectively blocks IL-23 inhibiting the release of important pro-inflammatory mediators, which helps to limit the inflammation that causes PsA symptoms,” he said.
Two phase 3 clinical trials – DISCOVER-1 and DISCOVER-2 – were instrumental in the PBS listing. A subcutaneous injection of guselkumab led to significant improvement in joints and skin plaques, physical functioning and fatigue compared to placebo. Its safety profile in the studies was consistent with that for plaque psoriasis patients, though bronchitis and decreased neutrophil count were observed.
“More than a quarter of people living with PsA who discontinue their current treatment do so because of adverse events or lack of efficacy, so the inclusion of Tremfya on the PBS for adults with active PsA for whom existing DMARD therapy is no longer effective or not tolerated is a very welcome option,” said Professor Nash, who was involved with the DISCOVER trials.
Dr Rani Sinnathurai, a rheumatologist at Royal North Shore Hospital, said: “The listing of guselkumab on the PBS offers another treatment option for people with PsA.
“It appears well tolerated and effective for both skin and joint manifestations disease, and its less frequent dosing may be preferred by some patients.”
