New efficacy and safety data presented at the EULAR E-Congress suggest that first-in-class Tremfy (guselkumab) benefits adult patients with active PsA who had inadequate response or intolerance to TNF inhibitors. Tremfya is a selective IL-23 inhibitor from Janssen Pharmaceutical Companies of Johnson & Johnson. 

In the COSMOS Phase 3b study, significantly higher proportions of patients treated with Tremfya showed joint symptom improvement and complete skin clearance versus placebo at week 24 in this true TNFi-IR patient population, which is often more difficult to treat.

People living with PsA can also suffer from sleep disorders, fatigue, stress, and depression. Janssen data shared at EULAR show the severity of skin and joint symptoms of active PsA was significantly associated with a higher loss of work productivity and impact on daily activity outside of work.

“We're showing very interesting and important data regarding the efficacy of guselkumab in patients who have psoriatic arthritis but who have previously failed one or more other biologics which in this case are TNF inhibitors. This is important because many patients don't respond very well to the first biologic, and we need to have more options for these patients as second- or third-line targeted treatment,” says Laure Gossec, MD, PhD, Professor of Rheumatology in Pitie-Salpetriere Hospital and Pierre & Marie Curie University in Paris, France.

Speaking to DermWire, Dr. Gossec highlighted data showing an improvement in skin disease as well as joint involvement. “Around one-third of patients with psoriasis may have some form of psoriatic arthritis which can manifest with swelling or joint pain.

The COSMOS study also shows that guselkumab is a very good option in terms of the skin in patients with PsA and concomitant psoriasis,” she says. “In the COSMOS trial, we showed that guselkumab is a very efficacious option on the skin as well as on the joints for patients who have failed or been inadequate responders to one or more TNF inhibitors.  In this specific study, guselkumab led to rapid improvement in skin psoriasis; and furthermore, the efficacy was of high magnitude and maintained.  As an example, the rate of PASI 100 response was 53 percent at one year in patients receiving guselkumab.”

She adds, “Our colleagues in dermatology know well that some pathways, such as the IL-17 and the IL-12/23 pathway, are good options for patients who have skin psoriasis but also psoriatic arthritis. The COSMOS study is important because it brings additional information on a population of patients who have already failed a previous biologic.”

Watch Dr. Gossec discuss her findings on DermWireTV.