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GuselkumabZoe SchillingApril 4, 2018Background and History:In the United States, about 7.5 million people are diagnosed with psoriasis.1Plaque psoriasis is a common chronic disease characterized by pervasive skin lesions called plaques.
This disease causes scaling, itching, and discomfort. Plaque psoriasis is caused by an overactive immune system. Although the distinct causes of plaque psoriasis are not entirely understood, researchers believe that there are many proteins in the immune system, including Interleukin 23 (IL-23), that may perform a role in skin plaque growth and inflammation.1Through clinical observation, Greek physician, Galen, first identified psoriasis as a skin disease.2 Henry Daggett Bulkley opened Broome Street Dispensaryin 1836, which was the first drug dispensary in the United States for the treatment of psoriasis and other dermatological ailments.2In the past, people thought that psoriasis resulted from allergies, microbes, poor nutrition, poor hygiene, or malfunctioning internal organs. Then biologic medications were introduced in the late 20th century. These medications target overactive immune cells that are causing the psoriasis. Today there are several different drugs on the market that are used to treat plaque psoriasis, including guselkumab.Guselkumab, the generic for Tremfya® is classified as a monoclonal antibody. Based on data collected by the pharmaceutical company, Janssen, the Food and Drug Administration (FDA) approved guselkumab on July 13, 2017.3Phase III clinical trials are designed to assess the value of a certain medication in clinical practice and evaluate the effectiveness of the new intervention.The three different Phase III clinical trials analyzed were NAVIGATE, VOYAGE 1, and VOYAGE 2.Chemistry:Guselkumab is classified as a monoclonal antibody that selectively blocks interleukin-23 (IL-23). As an inflammatory cytokine, IL-23 activates the CD4+ T-helper cell pathway to mediate the inflammatory cascade that induces psoriatic plaque formation.4Monoclonal antibody
medications like guselkumab are expected to be degraded into amino acids and small peptides bycatabolic pathways. This drug is administered as a subcutaneous injection.Its protein chemical formula is C6402H9864N1676O1994S42.5The average weight of the protein is143.6 kilograms per mole.5 Guselkumab is produced in a mammalian cell line byrecombinant DNA technology. The guselkumab injection is a sterile, colorless to light yellow solution that may contain small particles. Guselkumab should be stored in the refrigerator between 2°C to 8°C.6The drug should be stored in the original packaging to protect from light until use.6Pharmacology: Psoriasis is a chronic inflammatory skin disorder that affects 2% of the world population.7Evidence suggests that IL-23 has a major role in the pathogenesis of psoriasis. Guselkumab is a human monoclonal

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