Tremfya vs. Skyrizi: Comparing Uses, Side Effects, and Effectiveness

Do Tremfya and Skyrizi have generic or biosimilar versions?

Because both Tremfya and Skyrizi are biologics, they don’t have standard generic versions available.

• Tremfya
  • Available as a generic/biosimilar: no
  • Active ingredient: guselkumab
• Skyrizi:
  • Available as a generic/biosimilar: no
  • Active ingredient: risankizumab-rzaa

What conditions do Tremfya and Skyrizi treat?

Doctors prescribe Tremfya and Skyrizi for the same uses and indications, but the dosage and protocols may differ.

Tremfya is approved in adults for:

• moderate to severe plaque psoriasis
• active psoriatic arthritis
• moderately to severely active ulcerative colitis
• moderately to severely active Crohn’s disease

Skyrizi is approved for adults with the same conditions.

The main difference between Tremfya and Skyrizi is that Tremfya has pediatric approval (for children) for some uses, and the specific dosing and age/weight criteria differ.

Use in children

Tremfya has U.S. approval for children ages 6 and older who weigh at least 40 kg. Use in children is limited to plaque psoriasis and active psoriatic arthritis.

For Skyrizi, safety and effectiveness in people under 18 have not been established yet.

A healthcare professional can provide personalized information about the use of Tremfya in children.

Are the dosage and administration forms the same for Tremfya and Skyrizi?

Here’s how Tremfya and Skyrizi are typically administered, but it’s essential to follow the regimen prescribed by a healthcare professional.

Tremfya

• For plaque psoriasis (in adults and eligible children): 100 mg subcutaneous injection at weeks 0 and 4, and then every 8 weeks after that.
• For psoriatic arthritis (adults and eligible children): 100 mg subcutaneous injection at week 0 and week 4, and then every 8 weeks. Tremfya may be combined with other disease modifying anti-rheumatic drugs (DMARDs) if needed.
• For ulcerative colitis and Crohn’s (adults only): Administration can be intravenously (IV) or as a subcutaneous (under the skin) injection, with dosing adjusted according to individual needs.
  • IV: 200 mg at week 0, week 4, and week 8.
  • Injection: 400 mg at week 0, week 4, and week 8.
  • Maintenance: 100 mg injection at week 16, and every 8 weeks after that, or 200 mg injection at week 12, and every 4 weeks after that.

Skyrizi

• For plaque psoriasis and psoriatic arthritis (adults only): 150 mg subcutaneous injection at week 0 and week 4, and then every 12 weeks. Skyrizi can be used in combination with DMARDs.
• For ulcerative colitis (adults only): 1,200 mg by IV infusion over at least 2 hours at week 0, week 4, and week 8.
  • Maintenance: 180 mg or 360 mg by injection at week 12, and every 8 weeks after that.
• For Crohn’s disease (adults only): 600 mg by IV over at least 1 hour at week 0, week 4, and week 8.
  • Maintenance: The protocol is the same as that used in ulcerative colitis.

Self-administration

Both Skyrizi and Tremfya are designed to allow most people to self-inject their maintenance doses at home, after being trained by a healthcare professional. The front of your thigh or the abdomen (2 inches away from the belly button) are recommended injection sites.

Each drug comes in a pre-filled syringe or injector for under-the-skin use. Self-injections are typically possible once the initial doses have been administered by a professional and maintenance doses start.

Side effects and allergic reactions with Tremfya and Skyrizi

Because both drugs affect the immune system, side effects related to infections and overactive immune responses are possible.

For more detailed information, see the Tremfya and Skyrizi side effects articles.

Mild side effects

Tremfya and Skyrizi may cause mild side effects.

Tremfya and Skyrizi

• upper respiratory infections (cold, sore throat, stuffy nose)
• headache
• fatigue
• injection-site or IV site irritation, itching, or soreness
• joint or muscle pain
• stomach pain or diarrhea (especially if you have an inflammatory bowel condition)

These side effects are usually mild and temporary. However, if they persist or worsen, a healthcare professional can help explore the underlying causes and recommend next steps, including adjusting your dosing or changing your medication.

The following table provides a quick overview of the mild side effects.

This table may not include all mild side effects of these drugs. For more information on mild side effects, refer to the Tremfya drug prescribing information and the Skyrizi drug prescribing information.

Serious side effects

Serious side effects may also occur when taking these drugs.

Tremfya

• serious infections, like pneumonia or tuberculosis reactivation
• liver enzyme increases
• bilirubin increases
• allergic reactions, like swelling, hives, or difficulty breathing
• inflammatory bowel disease flare or onset (rare)

Skyrizi

• serious infections, including tuberculosis and fungal infections
• severe allergic reactions, including anaphylaxis
• liver problems, including hepatitis-like symptoms
• worsening of preexisting infections (rare)

If you develop signs of a serious infection, like fever, cough, chills, shortness of breath, or unexplained fatigue, seek medical care immediately.

The following table provides a quick overview of the serious side effects.

Allergic reactions

Alleric reactions can happen within minutes to hours of injection but sometimes appear later the same day or within 24 hours.

Severe allergic reactions (like anaphylaxis) can occur suddenly, even after previous uneventful doses.

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, stop injection and contact a healthcare professional right away. They may recommend an over-the-counter antihistamine and can determine whether you should keep taking your medication.

If you have symptoms of a severe allergic reaction, such as swelling or difficulty breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If a doctor confirms you’ve had a serious allergic reaction to a medication, they may have you switch to a different treatment.

How effective are Tremfya and Skyrizi?

In both the laboratory and real-world settings, Tremfya and Skyrizi demonstrate strong effectiveness for the indicated uses. Results vary based on the diagnosis, how long you’ve taken the drug, prior treatments, other therapies, and your body’s unique response.

For example, Tremfya was approved in adults with Crohn’s disease based on evidence that it was effective in moderately to severely active disease. Skyrizi was approved for the treatment of ulcerative colitis based on trials showing improvements in patients’ intestinal lining.

It’s essential to note that your results from Tremfya or Skyrizi may differ from those reported in these studies. Response times and durations may vary significantly as well.

Some people find it helpful to discuss effectiveness with their healthcare professionals. “Given my disease history, symptoms, and other treatments, what kind of improvement can I realistically expect?” may be a starting point for this discussion.

Cost of Tremfya and Skyrizi

Both Tremfya and Skyrizi are brand biologics with no generic versions, which means list prices may be higher. Your out-of-pocket costs depend on your insurance coverage, deductible, and any support programs or discounts you have access to.

Asking your insurance company to clarify out-of-pocket costs for Tremfya versus Skyrizi may be a first step. They may also be able to guide you about existing patient assistance or copay support programs for these drugs.

For more details about the cost of these drugs, see the Tremfaya cost and the Skyrizi cost articles.

What are the warnings for Tremfya and Skyrizi?

Tremfya and Skyrizi may not be right for you if you have certain medical conditions or other factors that affect your health. The prescribing information for these drugs refers to these factors as warnings or contraindications.

To understand potential risks or contraindications of your medication, consider sharing a detailed medical history with the prescribing doctor, particularly if you’ve had:

• tuberculosis (TB)
• allergic reactions to this and other drugs (even if mild)
• active infections or history of recurring infections
• live disease or elevated liver enzymes

These drugs may not be recommended for people who are currently pregnant or nursing.

Can people switch between Tremfya and Skyrizi?

The short answer: Yes. You may be able to switch between these two drugs with a doctor’s approval.

When Tremfya stops working well or causes side effects, doctors may switch you to Skyrizi. The reverse can happen too.

Before switching between Tremfya and Skyrizi, a healthcare professional may want to check for infections, update your tuberculosis test, review vaccine schedules, and monitor liver health, especially if you have Crohn’s or ulcerative colitis.

Usually, the new drug begins around the time your next dose is due, minimizing gaps in treatment.

Reminder: You should not switch drugs or stop your current treatment unless a doctor with access to your medical history recommends it.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.