Janssen Pharmaceuticals of Johnson & Johnson (J&J), a dominant player in the biopharmaceutical space, announced on 17 March 2023 its latest findings from real-world data analyses of Tremfya (guselkumab), a monoclonal antibody that binds to the p19 subunit of interleukin 23 (IL-23) and inhibits its interaction with the IL-23 receptor in bio-naïve and bio-experienced patients with moderate-to-severe plaque psoriasis (PsO) who are eligible to receive systemic therapy or phototherapy. According to the reported data, Tremfya exhibited superior long-term management of PsO symptoms compared to IL-17 inhibitors secukinumab and ixekizumab, as well as resulted in greater improvements in quality of life (Johnson & Johnson, 2023).

PsO is a systemic immune-mediated dermatological condition, which affects 2%–3% of the world’s population and which is linked to physical effects and debilitated quality of life (Damiani et al., 2021). J&J’s Tremfya represents the first and only fully human selective IL-23 inhibitor therapy to be approved in the US for individuals with moderate-to-severe PsO. Following an intravenous or subcutaneous administration of Tremfya 100mg, the agent selectively targets and binds with high affinity to the p19 subunit of IL-23, thus inhibiting interaction with and signalling of IL-23, a key driver and inflammatory cytokine in the pathogenesis of psoriasis. 

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The real-world data analysis conducted using the IBM MarketScan Research Databases revealed that Tremfya was associated with a greater treatment persistence and long-term control of moderate-to-severe PsO symptoms compared to secukinumab and ixekizumab among bio-naïve and bio-experienced patients. In the bio-naïve patient group, the Tremfya cohort exhibited 2.20 times longer persistence at 12 months, and 2.28 times longer persistence at 18 months when compared to the secukinumab cohort. When compared to the ixekizumab cohort, the Tremfya group exhibited a treatment persistence that was 1.84 longer at 12 months and 1.86 longer at 18 months. Among the bio-experienced adults, the Tremfya cohort demonstrated 2.00 and 2.04 times longer treatment persistence compared to the secukinumab cohort at 12 months and 18 months, respectively. Additionally, patients who received Tremfya exhibited 1.76 times and 1.67 times longer persistence when compared to the cohort that was administered ixekizumab at 12 months and 18 months, respectively.

The established efficacy of Tremfya was reinforced by J&J’s randomised, double-blind, placebo-controlled and active comparator-controlled Phase III VOYAGE 2 (NCT02207244) clinical trial results. The trial exhibited superior and durable clinical efficacy and safety of Tremfya, including changes in mean Psoriasis Symptoms and Signs Diary (PSSD) itch scores and quality-of-life improvements in adult patients with scalp PsO compared with a placebo and AbbVie’s Humira (adalimumab), a mega blockbuster and its direct competitor in the space. Among Tremfya responders, defined as patients achieving at least a 90% improvement in the Psoriasis Area and Severity Index 90 score, mean scalp-specific Investigator Global Assessment (ss-IGA) scores rapidly improved from 2.9 to 0.2 and to 0.3 at weeks 0, 24, and 48, respectively. J&J reported that the changes in the mean PSSD itch scores and Dermatology Life Quality Index scores aligned with the changes exhibited in the mean ss-IGA scores for all trialled Tremfya cohorts.

The data presented by Janssen at the 2023 American Academy of Dermatology Annual Meeting underlines the ability and potential of Tremfya to provide better long-term control of PsO symptoms when compared with secukinumab and ixekizumab. The positive results, its distinctive mechanism of action targeting the p19 subunit of IL-23, and its proven efficacy in scalp PsO highlight Tremfya’s role as a valuable management and treatment option for patients with moderate-to-severe PsO.

According to GlobalData’s Drugs Database Pharma Intelligence Center, with an analyst consensus global sales forecast of $8.6bn by 2029, Tremfya is set to become a blockbuster for the treatment of PsO, directly competing against formidable and established biologics in the space, including forging a rivalry with AbbVie’s Humira. Overall, GlobalData understands that the positive results position Tremfya as a leading drug in the growing PsO space. Janssen’s commitment to developing efficacious treatments for PsO, particularly in difficult-to-treat areas, is evident through the continued research and development of drugs like Tremfya and their emphasis on improving the quality of life of those affected by the condition.

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