Stelara and Tremfya Comparison

Stelara®(ustekinumab)	Tremfya®(guselkumab)
Prescription Only Stelara is an immunosuppressant medication that targets two inflammatory cytokines, IL-12 and IL-23, which are key contributors to chronic inflammation. For Crohn's disease and...	Prescription Only Tremfya, an interleukin inhibitor, is indicated for the treatment of plaque psoriasis or psoriatic arthritis in adults. Patients can learn to self-administer Tremfya...
Administration
Intravenous Infusion or Subcutaneous Injection . Learn more.	Subcutaneous injection. Learn more.
Dosing
Single intravenous infusion using weight-based dosing: Recommended Dosage up to 55 kg: 260 mg. > 55 kg to 85 kg: 390 mg. > 85 kg: 520 mg. Maintenance dosing: SubQ 90 mg dose 8 weeks after the initial intravenous dose, then every 8 weeks thereafter.. Learn more.	100 mg at Week 0, Week 4, and every 8 weeks thereafter. Learn more.
Latin Shorthand
Single IV infusion w/ weight-based dosing: Up to 55 kg: 260mg 55 to 85 kg: 390mg 85 kg: 520mg. Maintenance dosing: SubQ 90mg 8 wks after initial IV dose, then q8wks thereafter.. Learn more.	100 mg Week 0, 4, q8w. Learn more.
Out-Of-Pocket Costs With Copay Card
$5. Learn more.	$5. Learn more.
Annual Cap
Learn more.	$6,000. Learn more.
Assistance Expiration
End of each calendar year (subject to change or discontinuation without notice). Learn more.	End of each calendar year (subject to change or end without notice). Learn more.
Generics
No lower-cost generic available	No lower-cost generic available
Adverse Reactions
Most common adverse reactions are: • Psoriasis (≥3%): nasopharyngitis, upper respiratory tract infection, headache, and fatigue. • Crohn’s Disease, induction (≥3%): vomiting. • Crohn’s Disease, maintenance (≥3%): nasopharyngitis, injection site erythema, vulvovaginal candidiasis/mycotic infection, bronchitis, pruritus, urinary tract infection, and sinusitis. • Ulcerative colitis, induction (≥3%): nasopharyngitis • Ulcerative colitis, maintenance (≥3%): nasopharyngitis, headache, abdominal pain, influenza, fever, diarrhea, sinusitis, fatigue, and nausea . Learn more.	Most common (≥1%) adverse reactions associated with TREMFYA include upper respiratory infections, headache, injection site reactions, arthralgia, bronchitis, diarrhea, gastroenteritis, tinea infections, and herpes simplex infections. . Learn more.
Mechanism of Actions (MoA)
Interleukin 12 Antagonist; Interleukin 23 Antagonist . Learn more.	Interleukin 23 Antagonist. Learn more.
Special Populations
Is STELARA® safe to use during pregnancy? Limited data on the use of STELARA® in pregnant women are insufficient to inform a drug-associated risk. Animal studies have not shown any adverse effects, but the background risk of major birth defects and miscarriage for the indicated population(s) is unknown. Pregnant women should only use STELARA® if the potential benefits outweigh the risks. Is it safe to use STELARA® while breastfeeding? There is no data on the presence of ustekinumab in human milk or the effects on milk production or the breastfed infant. Ustekinumab was present in the milk of lactating monkeys administered ustekinumab. Breastfeeding women should only use STELARA® if the potential benefits outweigh the risks. Can children use STELARA®? STELARA® is approved for the treatment of moderate to severe plaque psoriasis in pediatric patients 6 to 17 years old, and psoriatic arthritis in pediatric patients 6 to 17 years old. Use in patients less than 6 years of age with psoriasis or psoriatic arthritis or in pediatric patients with Crohn’s disease or ulcerative colitis has not been established. Is STELARA® safe for geriatric patients? Although no overall differences in safety or efficacy were observed between older and younger patients, the number of patients aged 65 and over is not sufficient to determine whether they respond differently from younger patients. Geriatric patients using STELARA® may have a higher frequency of serious infection, so caution should be used when treating them.	Is TREMFYA safe to use during pregnancy? There are no available data on TREMFYA use in pregnant women to inform a drug associated risk of adverse developmental outcomes. Human IgG antibodies are known to cross the placental barrier; therefore, TREMFYA may be transmitted from the mother to the developing fetus. In a combined embryofetal development and pre- and post-natal development study, no adverse developmental effects were observed in infants born to pregnant monkeys after subcutaneous administration of guselkumab during organogenesis through parturition at doses up to 30 times the maximum recommended human dose (MRHD). Neonatal deaths were observed at 6- to 30-times the MRHD. All pregnancies have a background risk of birth defect, loss, or other adverse outcomes. The estimated background risk of major birth defects and miscarriage for the indicated population is unknown. Pregnant women should discuss the potential risks and benefits of TREMFYA with their healthcare provider. Is there a pregnancy exposure registry for TREMFYA? Yes, there is a pregnancy registry that monitors pregnancy outcomes in women exposed to TREMFYA during pregnancy. Patients should be encouraged to enroll by calling 1-877-311-8972. What is the estimated background risk of major birth defects and miscarriage in the general population? In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively. What animal data is available for TREMFYA use during pregnancy? In a combined embryofetal development and pre- and post-natal development study, pregnant cynomolgus monkeys were administered weekly subcutaneous doses of guselkumab up to 50 mg/kg (30 times the MRHD based on a mg/kg comparison) from the beginning of organogenesis to parturition. Neonatal deaths occurred in the offspring of one control monkey, three monkeys administered guselkumab at 10 mg/kg/week (6 times the MRHD based on a mg/kg comparison) and three monkeys administered guselkumab at 50 mg/kg/week (30 times the MRHD based on a mg/kg comparison). The clinical significance of these findings is unknown. No guselkumab-related effects on functional or immunological development were observed in the infants from birth through 6 months of age. What are the risks associated with guselkumab use during lactation? There is no data on the presence of guselkumab in human milk or the effects on the breastfed infant or milk production. Maternal IgG is known to be present in human milk. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for TREMFYA and any potential adverse effects on the breastfed infant from TREMFYA or from the underlying maternal condition. Is TREMFYA safe and effective for use in pediatric patients? The safety and efficacy of TREMFYA in pediatric patients (less than 18 years of age) have not been established. Are there differences in safety or effectiveness of TREMFYA in geriatric patients? No overall differences in safety or effectiveness were observed between older and younger subjects who received TREMFYA. However, the number of subjects aged 65 years and older was not sufficient to determine whether they respond differently from younger subjects.

Stelara®(ustekinumab)

Tremfya®(guselkumab)

Prescription Only

Stelara is an immunosuppressant medication that targets two inflammatory cytokines, IL-12 and IL-23, which are key contributors to chronic inflammation. For Crohn's disease and...

Prescription Only

Tremfya, an interleukin inhibitor, is indicated for the treatment of plaque psoriasis or psoriatic arthritis in adults. Patients can learn to self-administer Tremfya...

Dosage & Administration

Administration

Intravenous Infusion or Subcutaneous Injection . Learn more.

Subcutaneous injection. Learn more.

Dosing

Single intravenous infusion using weight-based dosing: Recommended Dosage up to 55 kg: 260 mg. > 55 kg to 85 kg: 390 mg. > 85 kg: 520 mg. Maintenance dosing: SubQ 90 mg dose 8 weeks after the initial intravenous dose, then every 8 weeks thereafter.. Learn more.

100 mg at Week 0, Week 4, and every 8 weeks thereafter. Learn more.

Latin Shorthand

Single IV infusion w/ weight-based dosing: Up to 55 kg: 260mg 55 to 85 kg: 390mg 85 kg: 520mg. Maintenance dosing: SubQ 90mg 8 wks after initial IV dose, then q8wks thereafter.. Learn more.

100 mg Week 0, 4, q8w. Learn more.

Financial Assistance

Out-Of-Pocket Costs With Copay Card

$5. Learn more.

Annual Cap

Learn more.

$6,000. Learn more.

Assistance Expiration

End of each calendar year (subject to change or discontinuation without notice). Learn more.

End of each calendar year (subject to change or end without notice). Learn more.

Generics

No lower-cost generic available

Physician Advisory

Adverse Reactions

Most common adverse reactions are: • Psoriasis (≥3%): nasopharyngitis, upper respiratory tract infection, headache, and fatigue. • Crohn’s Disease, induction (≥3%): vomiting. • Crohn’s Disease, maintenance (≥3%): nasopharyngitis, injection site erythema, vulvovaginal candidiasis/mycotic infection, bronchitis, pruritus, urinary tract infection, and sinusitis. • Ulcerative colitis, induction (≥3%): nasopharyngitis • Ulcerative colitis, maintenance (≥3%): nasopharyngitis, headache, abdominal pain, influenza, fever, diarrhea, sinusitis, fatigue, and nausea . Learn more.

Most common (≥1%) adverse reactions associated with TREMFYA include upper respiratory infections, headache, injection site reactions, arthralgia, bronchitis, diarrhea, gastroenteritis, tinea infections, and herpes simplex infections. . Learn more.

Mechanism of Actions (MoA)

Interleukin 12 Antagonist; Interleukin 23 Antagonist . Learn more.

Interleukin 23 Antagonist. Learn more.

Special Populations

Is STELARA® safe to use during pregnancy?

Limited data on the use of STELARA® in pregnant women are insufficient to inform a drug-associated risk. Animal studies have not shown any adverse effects, but the background risk of major birth defects and miscarriage for the indicated population(s) is unknown. Pregnant women should only use STELARA® if the potential benefits outweigh the risks.

Is it safe to use STELARA® while breastfeeding?

There is no data on the presence of ustekinumab in human milk or the effects on milk production or the breastfed infant. Ustekinumab was present in the milk of lactating monkeys administered ustekinumab. Breastfeeding women should only use STELARA® if the potential benefits outweigh the risks.

Can children use STELARA®?

STELARA® is approved for the treatment of moderate to severe plaque psoriasis in pediatric patients 6 to 17 years old, and psoriatic arthritis in pediatric patients 6 to 17 years old. Use in patients less than 6 years of age with psoriasis or psoriatic arthritis or in pediatric patients with Crohn’s disease or ulcerative colitis has not been established.

Is STELARA® safe for geriatric patients?

Although no overall differences in safety or efficacy were observed between older and younger patients, the number of patients aged 65 and over is not sufficient to determine whether they respond differently from younger patients. Geriatric patients using STELARA® may have a higher frequency of serious infection, so caution should be used when treating them.

Is TREMFYA safe to use during pregnancy?

There are no available data on TREMFYA use in pregnant women to inform a drug associated risk of adverse developmental outcomes. Human IgG antibodies are known to cross the placental barrier; therefore, TREMFYA may be transmitted from the mother to the developing fetus. In a combined embryofetal development and pre- and post-natal development study, no adverse developmental effects were observed in infants born to pregnant monkeys after subcutaneous administration of guselkumab during organogenesis through parturition at doses up to 30 times the maximum recommended human dose (MRHD). Neonatal deaths were observed at 6- to 30-times the MRHD. All pregnancies have a background risk of birth defect, loss, or other adverse outcomes. The estimated background risk of major birth defects and miscarriage for the indicated population is unknown. Pregnant women should discuss the potential risks and benefits of TREMFYA with their healthcare provider.

Is there a pregnancy exposure registry for TREMFYA?

Yes, there is a pregnancy registry that monitors pregnancy outcomes in women exposed to TREMFYA during pregnancy. Patients should be encouraged to enroll by calling 1-877-311-8972.

What is the estimated background risk of major birth defects and miscarriage in the general population?

In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively.

What animal data is available for TREMFYA use during pregnancy?

In a combined embryofetal development and pre- and post-natal development study, pregnant cynomolgus monkeys were administered weekly subcutaneous doses of guselkumab up to 50 mg/kg (30 times the MRHD based on a mg/kg comparison) from the beginning of organogenesis to parturition. Neonatal deaths occurred in the offspring of one control monkey, three monkeys administered guselkumab at 10 mg/kg/week (6 times the MRHD based on a mg/kg comparison) and three monkeys administered guselkumab at 50 mg/kg/week (30 times the MRHD based on a mg/kg comparison). The clinical significance of these findings is unknown. No guselkumab-related effects on functional or immunological development were observed in the infants from birth through 6 months of age.

What are the risks associated with guselkumab use during lactation?

There is no data on the presence of guselkumab in human milk or the effects on the breastfed infant or milk production. Maternal IgG is known to be present in human milk. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for TREMFYA and any potential adverse effects on the breastfed infant from TREMFYA or from the underlying maternal condition.

Is TREMFYA safe and effective for use in pediatric patients?

The safety and efficacy of TREMFYA in pediatric patients (less than 18 years of age) have not been established.

Are there differences in safety or effectiveness of TREMFYA in geriatric patients?

No overall differences in safety or effectiveness were observed between older and younger subjects who received TREMFYA. However, the number of subjects aged 65 years and older was not sufficient to determine whether they respond differently from younger subjects.

Stelara® Alternatives