The Medical Letter on Drugs and Therapeutics
Issue 1533
Guselkumab (Tremfya) for Psoriasis; Edaravone (Radicava) for ALS; Lesinurad/Allopurinol (Duzallo) for Gout-Associated Hyperuricemia; Cotempla XR-ODT - Another Long-Acting Methylphenidate for ADHD; Abemaciclib (Verzenio) - A Third CDK 4/6 Inhibitor for Breast Cancer
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Guselkumab (Tremfya) for Psoriasis

The FDA has approved the interleukin (IL)-23 blocker guselkumab (Tremfya – Janssen) for treatment of moderate to severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy. Guselkumab is the first selective IL-23 blocker to become available in the US.

MECHANISM OF ACTION — IL-23 is a cytokine involved in normal inflammatory and immune responses. Guselkumab is a fully human monoclonal IgG1 antibody that selectively binds to the p19 subunit of IL-23, inhibiting it from binding to the IL-23 receptor and preventing downstream release of pro-inflammatory cytokines (such as IL-17A) and chemokines.

STANDARD TREATMENT — Plaque psoriasis is a chronic, inflammatory, immune-mediated disorder. Mild to moderate psoriasis is generally treated with topical corticosteroids. Topical vitamin D analogs and the retinoid tazarotene (Tazorac, and others) ... more      

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