Guselkumab (Tremfya)

SELF ADMINISTRATION

Indications for Prior Authorization:

  • Treatment of adults with moderate-to-severe plaque psoriasis who are candidates for systemic therapy or phototherapy

Tremfya is a preferred biologic agent for treatment of plaque psoriasis when all criteria below are met

Patients must meet the following criteria for the indications above:

  • Patient is 18 years or older, AND
  • Diagnosis of chronic moderate-to-severe plaque psoriasis confirmed by a dermatologist (psoriasis affects 10% or more of the body; psoriasis involves hands, feet, head, and neck or genitalia), AND
  • Prescribed by dermatologist, AND
  • Patient has tried and failed topical therapy (e.g., Dovonox, Tazorac, other topical steroids), AND
  • Documented failure or clinically significant adverse effects to at least one of the following therapies alone or in combination, unless contraindicated: methotrexate (doses up to 15-20 mg per week) or (if methotrexate is contraindicated) cyclosporine, aceitretin, or a trial with PUVA or UVB for at least 3 months unless intolerant

Dosing:

  • 100 mg at week 0, week 4, and every 8 weeks thereafter.

Initial Approval:

  • 3 months to assess patient's response

Renewal:

  • Initial: 3 months to assess patient's response
  • Renewal: 1 year

Risk of Tuberculosis:

  • Patients should be evaluated for latent tuberculosis infection with a TB skin test.  Treatment of latent tuberculosis infection should be initiated prior to therapy with Tremfya

Last review date: May 1, 2019