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TREMFYA - Use in Adult Patients With Plaque Psoriasis or Psoriatic Arthritis and Comorbid Diabetes Mellitus

Last Updated: 03/20/2025

SUMMARY

  • The company cannot recommend any practices, procedures, or usage that deviate from the approved labeling.
  • Phase 3 clinical trials for moderate to severe plaque psoriasis (PsO; VOYAGE 1, VOYAGE 2, NAVIGATE, ECLIPSE, and ORION) and for active psoriatic arthritis (PsA; DISCOVER-1 and DISCOVER-2) included patients with a medical history of diabetes mellitus.1-7
  • Adult patients with plaque PsO or PsA and comorbid diabetes mellitus treated with TREMFYA have been identified in a retrospective study and patient registries.8-11

CLINICAL Data in moderate to severe plaque psoriasis

VOYAGE 1 and VOYAGE 2

Blauvelt et al (2017)12 and Reich et al (2017)13 reported results from VOYAGE 1 and VOYAGE 2, respectively, phase 3, multicenter, randomized, double-blind, placebo and active comparator-controlled studies evaluating the efficacy and safety of TREMFYA compared to placebo and adalimumab in patients with moderate to severe PsO.

Results

Patient Characteristics

Patients With Medical History and Current Diagnoses of Diabetes Mellitus From VOYAGE 1 and VOYAGE 21,2
Placebo
TREMFYA
Adalimumab
VOYAGE 1
   Analysis set: Patients randomized at week 0, n
174
329
334
   Diabetes mellitus, n (%)
16 (9.2)
22 (6.7)
30 (9.0)
VOYAGE 2
   Analysis set: Patients randomized at week 0, n
248
496
248
   Diabetes mellitus, n (%)
22 (8.9)
50 (10.1)
21 (8.5)

NAVIGATE

Langley et al (2018)14 evaluated the safety and efficacy of TREMFYA in NAVIGATE, a phase 3, randomized, double-blind, active comparator-controlled study in patients with moderate to severe PsO with an adequate response to ustekinumab.

Results

Patient Characteristics

Patients With Medical History and Current Diagnoses of Diabetes Mellitus From NAVIGATE3
TREMFYA
Ustekinumab
Analysis set: Randomized patients, n
135
133
Diabetes mellitus, n (%)
4 (3.0)
15 (11.3)

ECLIPSE

Reich et al (2019)15 reported results from ECLIPSE, a phase 3, multicenter, randomized, double-blind, comparator-controlled study evaluating the superiority of clinical response at week 48 for TREMFYA over that of secukinumab in patients with moderate to severe plaque PsO.

Results

Patient Characteristics

Patients With Medical History and Current Diagnoses of Diabetes Mellitus From ECLIPSE4 
TREMFYA
100 mg

Secukinumab
300 mg

Total
Full analysis set, n
534
514
1048
Diabetes mellitus, n (%)
72 (13.5)
64 (12.5)
136 (13.0)

ORION

Ferris et al (2020)16 reported results from ORION, a phase 3, multicenter, randomized, double-blind, placebo-controlled study evaluating the efficacy, safety, and pharmacokinetics of TREMFYA vs placebo (both delivered via the One-Press device) in patients with moderate to severe PsO.

Results

Patient Characteristics

Patients With Medical History and Current Diagnoses of Diabetes Mellitus From ORION5 
Placebo
TREMFYA
Total
Full analysis set, n
16
62
78
Diabetes mellitus, n (%)
1 (6.3)
13 (21.0)
14 (17.9)

Retrospective Study

Marcelli et al (2024)8 evaluated patients who were super responders (defined as patients who achieved Psoriasis Area and Severity Index [PASI 0] by week 20 of treatment) in a retrospective, observational, cross-sectional, “snapshot,” single-center study that included adult patients with moderate to severe chronic plaque PsO treated with at least 3 doses of TREMFYA monotherapy.

  • Inclusion criteria:
    • Patients (age ≥18 years) who were receiving at least 3 doses of TREMFYA monotherapy for moderate to severe chronic plaque psoriasis and not responding to or showing contraindications or side effects to ≥1 conventional systemic therapy
    • Patients with PASI score ≥10 and body surface area (BSA) ≥10% at baseline, or with PASI score <10 and BSA <10% at baseline, as well as involvement of specific sensitive areas (ie, the face, scalp, hands, nails, soles of the feet, or genital areas), according to Italian law
  • PASI 90/100 responses were evaluated at baseline, week 4 of treatment, and every 8 weeks thereafter.
  • A total of 232 patients treated with TREMFYA monotherapy for at least 28 weeks (from November 2018 to November 2023) were included in this study.
  • At baseline, 12.1% (28/232) of patients were reported to have comorbid diabetes mellitus.

Menéndez Sánchez et al (2023)9 evaluated patients who were super responders (defined as achieving PASI 0 at weeks 16 and 24 of treatment) in a retrospective, observational, bicentric study that included adult patients with moderate to severe plaque PsO treated with TREMFYA.

  • A total of 86 patients were included, of whom 49 received TREMFYA, 24 received risankizumab, and 13 received tildrakizumab.
  • Patients with a medical history of diabetes mellitus at baseline are noted in Table: Patients With Medical History of Diabetes Mellitus.

Patients With Medical History of Diabetes Mellitus9
Diabetes Mellitus, %
Super Responders
Non-Super Responders
Total
TREMFYA
9
27
18
Risankizumab
14
30
21
Tildrakizumab
0
18
15

CorEvitas PsO Registry

Armstrong et al (2023)10 reported results from the CorEvitas (previously known as Corrona) PsO Registry, a prospective, observational cohort of adult patients with moderate to severe plaque PsO.

  • The analysis from July 2017 to March 2020 included 113 adult patients with moderate to severe plaque PsO who initiated TREMFYA at or after enrollment and had a follow-up visit after 9-12 months of treatment with TREMFYA.
  • At baseline, 18.6% (21/113) of patients had a history of diabetes mellitus.

CLINICAL Data in active psoriatic arthritis

DISCOVER-1 and DISCOVER-2

Deodhar et al (2020)17 and Mease et al (2020)18 evaluated the efficacy and safety of TREMFYA in DISCOVER-1 and DISCOVER-2, respectively, phase 3, randomized, multicenter, double-blind, placebo-controlled studies in adult patients with active PsA.

Results

Patient Characteristics

Patients With Medical History and Current Diagnoses of Diabetes Mellitus From DISCOVER-1 and DISCOVER-26,7
Placebo
TREMFYA q8w
TREMFYA q4w
DISCOVER-1
   Full analysis set: randomized patients, n
126
127
128
   Diabetes mellitus, n (%)
15 (11.9)
11 (8.7)
13 (10.2)
DISCOVER-2
   Full analysis set: randomized patients, n
246
248
245
   Diabetes mellitus, n (%)
18 (7.3)
26 (10.5)
19 (7.8)
Abbreviations: q4w, every 4 weeks; q8w, every 8 weeks.

CorEvitas PsA/Spondyloarthritis Registry

Mease et al (2022)11,19 reported characteristics of patients with rheumatologist-diagnosed PsA treated with TREMFYA from the CorEvitas PsA/Spondyloarthritis Registry, a United States prospective, observational, noninterventional registry.

  • Inclusion criteria19:
    • Patients (age ≥18 years) who had a diagnosis of PsA and initiated on a United States Food and Drug Administration (USFDA)-approved PsA medication at the enrollment.
    • Patients who met Assessment of Spondyloarthritis International Society (ASAS) criteria for radiographic or nonradiographic axial spondyloarthritis (AxSpA), and initiated on a USFDA- approved biologic or biosimilar treatment of AS or AxSpA at the enrollment.
    • Patients who met the modified New York classification criteria for AS and initiated on a USFDA-approved biologic and biosimilar for the treatment of AS or AxSpA at enrollment.
  • During routine clinical visits every 6 months, patients and providers complete questionnaires on patient demographics, disease characteristics, PsA medication history, medical history and lifestyle characteristics, disease activity and severity, comorbidities, and adverse events (including infections, hospitalizations, and other targeted safety outcomes).11 
  • The analysis from March 2017 to September 2021 included biologic-naïve and biologic-experienced patients who initiated TREMFYA at or after enrollment.
  • There were 113 patients diagnosed with PsA and treated with TREMFYA, of which 26% (29/113) had comorbid diabetes mellitus.

LITERATURE SEARCH

A literature search of MEDLINE®, EMBASE®, BIOSIS Previews®, and DERWENT® (and/or other resources, including internal/external databases) was conducted on 17 March 2025.

 

References

1 Data on File. Guselkumab. VOYAGE 1 48-Week Clinical Study Report. Janssen Research & Development, LLC. EDMS-ERI- 05080478, 1.0; 2016.  
2 Data on File. Guselkumab. VOYAGE 2 48-Week Clinical Study Report. Janssen Research & Development, LLC. EDMS-ERI- 105177316; 2016.  
3 Data on File. Guselkumab. NAVIGATE 40-Week Clinical Study Report. Janssen Research & Development, LLC. EDMS-ERI-105363698; 2016.  
4 Data on File. Guselkumab. ECLIPSE 56-Week Final Clinical Study Report. Janssen Research & Development, LLC. EDMS-ERI-167662744; 2019.  
5 Data on File. Guselkumab. ORION 20-Week Clinical Study Report. Janssen Research & Development, LLC. EDMS-ERI-147187765, 2.0; 2018.  
6 Data on File. Guselkumab. DISCOVER-1 24-Week Clinical Study Report. Janssen Research & Development, LLC. EDMS-ERI- 178052231; 2019.  
7 Data on File. Guselkumab. DISCOVER-2 24-Week Clinical Study Report. Janssen Research & Development, LLC. EDMS-ERI- 178056864, 2.0; 2019.  
8 Marcelli L, Belcastro A, Talamonti M, et al. Characterization of super-responder profile in chronic plaque psoriatic patients under guselkumab treatment: a long-term real-life experience. J Clin Med. 2024;13(17):5175.  
9 Menéndez Sánchez M, Muñiz de Lucas A, Pérez Fernández E, et al. Super‐responders in psoriasis under interleukin 23 inhibitor treatments, experience in two centres. J Eur Acad Dermatol Venereol. 2023;37(11):e1321-e1322.  
10 Armstrong AW, Fitzgerald T, McLean RR, et al. Real-world effectiveness of 9-12 months of guselkumab therapy among patients with moderate-to-severe plaque psoriasis in the CorEvitas Psoriasis Registry. Dermatol Ther (Heidelb). 2023;13(2):629-640.  
11 Mease PJ, Ogdie A, Chakravarty SD, et al. Clinical characteristics of registry participants with psoriatic arthritis initiating guselkumab: an analysis from the CorEvitas psoriatic arthritis/spondyloarthritis registry. Drugs Real World Outcomes. 2022;9(4):617-628.  
12 Blauvelt A, Papp K, Griffiths C, et al. Efficacy and safety of guselkumab, an anti-interleukin-23 monoclonal antibody, compared with adalimumab for the continuous treatment of patients with moderate to severe psoriasis: results from the phase 3, double-blinded, placebo- and active comparator-controlled VOYAGE 1 trial. J Am Acad Dermatol. 2017;76(3):405-417.  
13 Reich K, Armstrong AW, Foley P, et al. Maintenance of response through up to 4 years of continuous guselkumab treatment of psoriasis in the VOYAGE 2 phase 3 study. Am J Clin Dermatol. 2020;21(6):881-890.  
14 Langley RG, Tsai TF, Flavin S, et al. Efficacy and safety of guselkumab in patients with psoriasis who have an inadequate response to ustekinumab: results of the randomized, double-blind, phase III NAVIGATE trial. Br J Dermatol. 2018;178(1):114-123.  
15 Reich K, Armstrong AW, Langley RG, et al. Guselkumab versus secukinumab for the treatment of moderate-to-severe psoriasis (ECLIPSE): results from a phase 3, randomised controlled trial. Lancet. 2019;394(10201):831-839.  
16 Ferris LK, Ott E, Jiang J, et al. Efficacy and safety of guselkumab, administered with a novel patient-controlled injector (One-Press), for moderate-to-severe psoriasis: results from the phase 3 ORION study. J Dermatolog Treat. 2020;31(2):152-159.  
17 Deodhar A, Helliwell PS, Boehncke WH, et al. Guselkumab in patients with active psoriatic arthritis who were biologic-naive or had previously received TNFα inhibitor treatment (DISCOVER-1): a double-blind, randomised, placebo-controlled phase 3 trial [published correction appears in Lancet. 2020 Apr 4;395(10230):1114]. Lancet. 2020;395(10230):1115-1125.  
18 Mease PJ, Rahman P, Gottlieb AB, et al. Guselkumab in biologic-naive patients with active psoriatic arthritis (DISCOVER-2): a double-blind, randomised, placebo-controlled phase 3 trial [published correction appears in Lancet. 2020 Apr 4;395(10230):1114]. Lancet. 2020;395(10230):1126-1136.  
19 Mease PJ, Ogdie A, Chakravarty SD, et al. Supplement to: Clinical characteristics of registry participants with psoriatic arthritis initiating guselkumab: an analysis from the CorEvitas psoriatic arthritis/spondyloarthritis registry. Drugs Real World Outcomes. 2022;9(4):617-628.