A Practical Guide to Guselkumab for Psoriasis, IBD, and Psoriatic Arthritis
Leanne Edwards, BSN, RN, IgCN, Clinical Nurse Educator - January 16, 2026
TREMFYA® is a biologic therapy known as a monoclonal antibody. It works by targeting and blocking interleukin-23 (IL-23), a key player in inflammation. When IL-23 is overactive, it can contribute to chronic diseases of the skin, joints, and digestive tract. By blocking IL-23, this therapy helps reduce inflammation and prevent flare-ups, thereby improving quality of life.
Who Can Take Tremfya®
- Plaque psoriasis: Adults and children 6+ years (> 40 kg)
- Psoriatic arthritis: Adults and children 6+ years (> 40 kg)
- Ulcerative colitis: Adults with moderate to severe disease
- Crohn’s disease: Adults with moderate to severe disease
How Tremfya® Is Given
Depending on the condition being treated, TREMFYA® may be administered subcutaneously or intravenously.
Subcutaneous Injection
- Each prefilled pen, prefilled syringe, or One-Press Injector is intended for one-time use in a single patient only and comes with a pre-attached needle.
- Adults can self-inject; children need a caregiver or nurse.
- Allow medication to warm to room temperature for about 30 minutes before injection.
- Inject within 5 minutes of removing needle cover.
- Appropriate injection sites are the back of upper arms (if caregiver administered), front of thighs, and lower abdomen. Avoid injecting 2 inches around the umbilicus and in areas with scars, broken or infected skin, stretch marks, visible blood vessels, bony areas, bruised areas and tattoos. Rotate injection sites.
Intravenous Infusion
- IV induction is optional for ulcerative colitis and Crohn’s disease.
- After the initial induction phase to establish therapeutic levels, all ongoing maintenance doses are administered subcutaneously.
- Withdraw then discard 20 mL from a 0.9% Sodium Chloride 250 mL intravenous bag, which is equal to the volume of TREMFYA® to be added.
- Withdraw 20 mL of TREMFYA® from the vial and add it to the of 0.9% Sodium Chloride intravenous bag to yield a final concentration of 0.8 mg/mL. Gently swirl the bag to mix.
- Visually inspect the diluted solution for particulate matter and discoloration before infusion.
- Use only an infusion set with an in-line, sterile, non-pyrogenic, low protein binding filter (pore size 0.2 micrometer).
- Do not infuse TREMFYA® concomitantly in the same intravenous line with other medicinal products.
- Infuse the diluted solution over a period of at least one hour.
TREMFYA® Dosing
|
Condition
|
Route of Administration
|
Induction Dose
|
Maintenance Dose
|
• Plaque Psoriasis
• Psoriatic Arthritis
|
SUBQ
|
100 mg at Week 0 and Week 4
|
100 mg every 8 weeks
|
• Crohn’s Disease
•Ulcerative Colitis
|
IV or SUBQ for induction, then SUBQ
|
IV Option: 200 mg IV at Week 0, 4, 8
SUBQ Option: 400 mg SUBQ (two 200 mg injections) at Week 0, 4, 8
|
Option 1: 100 mg SUBQ at Week 16, then every 8 weeks
Option 2: 200 mg SUBQ at Week 12, then every 4 weeks
|
Safety/Precautions
Highlights:
- Nufactor does not require an anaphylaxis kit.
- TB test required.
- Liver enzymes and bilirubin should be checked in ulcerative colitis and Crohn’s patients.
- Avoid live vaccines and therapeutic infectious agents including measles, mumps and rubella (MMR), varicella (chicken pox), zoster vaccine live (Zostavax®), live intranasal influenza virus (FluMist®), yellow fever or therapeutic infectious agents such as bacillus Calmette-Guerin (BCG).
- If newly pregnant or breastfeeding, inform Nufactor.
Prior to administering each dose.
- Screen for infusion related reactions (IV), SUBQ site reactions (SUBQ) and other adverse reactions to past doses.
- Screen for active infections, including recent surgery w/incision drainage. If present, do not begin treatment and notify Nufactor.
- Screen for TB symptoms: Severe cough lasting 3 weeks or longer, chest pain, coughing up blood or sputum, weakness or fatigue, unexplained weight loss, loss of appetite, chills, fever, night sweats. If present, do not begin treatment and notify Nufactor.
Allergic or Injection Reactions
Most reactions are mild, but serious allergic reactions are possible.
Common Side Effects
- Bronchitis
- Diarrhea
- Headache
- Infections (such as fungal skin, herpes simplex, respiratory tract, stomach flu)
- Joint pain
- SUBQ injection site reactions (redness, swelling, itching, pain, bruising, tingling or hardness).
If severe allergic reaction (angioedema, wheezing, difficulty breathing and swelling of eyelids or lips): Immediately stop the infusion and disconnect from the patient (if in progress), call 911, initiate CPR as necessary, wait for paramedics to arrive and then contact the provider/Nufactor.
Tips for Patients Receiving Tremfya®
- Keep a symptom journal-especially for Crohn’s disease and ulcerative colitis, where subtle changes can be important.
- If SUBQ, rotate injection sites.
- Report infection symptoms right away.
- Store TREMFYA® correctly-keep refrigerated and warm to room temperature for about 30 minutes before injecting.
- Ask the healthcare team questions.
TREMFYA® offers a targeted and effective option for patients living with chronic inflammatory conditions. With proper monitoring and support, many people achieve long-lasting symptom control and improved daily comfort. Nufactor is proud to partner with patients and providers to deliver safe, reliable therapy at home.
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