New TREMFYA® (guselkumab) study shows consistent perianal fistula remission across key Crohn's disease patient subgroups
Week 24 remission rates exceeded placebo in patients with prior biologic exposure and in groups with or without proctitis.
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Rhea-AI Summary
Johnson & Johnson (JNJ) announced Phase 3 TREMFYA results showing greater fistula remission than placebo across Crohn's disease patient subgroups.
The prespecified FUZION analyses assessed Week 24 combined fistula remission. Previously reported overall rates were 28% with 100 mg injected under the skin every eight weeks and 27% with 200 mg every four weeks, versus 10% with placebo. Among patients with prior biologic exposure, corresponding rates were 21% and 29%, versus 5%. Higher remission rates than placebo were also reported in patients with greater intestinal disease activity and those with or without proctitis, or rectal inflammation.
Remission required closure of all external fistula openings without drainage or new fistulas, and no underlying fluid collections on MRI. Adverse events were consistent with TREMFYA's known Crohn's disease safety profile.
Positive
- Minor pointOverall Week 24 remission reached 28% with 100 mg every eight weeks and 27% with 200 mg every four weeks, versus 10% placebo.
- Minor pointPrior-biologic-exposure subgroup Week 24 remission reached 21% with 100 mg every eight weeks and 29% with 200 mg every four weeks, versus 5% placebo.
- Minor pointHigher disease activity subgroup (CDAI ≥220) Week 24 remission reached 30% with 100 mg every eight weeks and 21% with 200 mg every four weeks, versus 0% placebo.
- Minor pointBaseline proctitis subgroup Week 24 remission reached 26% with 100 mg every eight weeks and 27% with 200 mg every four weeks, versus 12% placebo.
- Minor pointWithout baseline proctitis, Week 24 remission reached 29% with 100 mg every eight weeks and 27% with 200 mg every four weeks, versus 10% placebo.
- Minor pointAdverse events were consistent with the known safety profile of TREMFYA in Crohn's disease.
Negative
- None.
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- New prespecified analyses showed consistent findings across clinically important and difficult to treat subgroups, including patients with prior biologic exposure
- Findings build on first positive results where TREMFYA achieved combined fistula remission rates of up to
28% across dosing groups - Results come from the first dedicated Phase 3 randomized, placebo-controlled trial in adults managing Crohn's disease with perianal fistula in more than 20 years

In the overall study population,
New subgroup analyses show consistent outcomes across key patient subgroups
Expanding on previously reported results in the overall population, new prespecified subgroup analyses showed greater Week 24 combined fistula remission with TREMFYA versus placebo among:1
- Patients with greater luminal disease activity at baseline (CDAI ≥220):
30% and21% with TREMFYA 100 mg SC q8w and 200 mg SC q4w, respectively, versus0% with placebo - Patients with prior biologic exposure:
21% and29% , respectively, versus5% with placebo - Patients with proctitis at baseline:
26% and27% , respectively, versus12% with placebo - Patients without proctitis at baseline:
29% and27% , respectively, versus10% with placebo
Adverse events were consistent with the known safety profile of TREMFYA in Crohn's disease.1
"Perianal fistula remain one of the most debilitating manifestations of moderate to severe Crohn's disease and many patients continue to experience persistent drainage, pain and complications," said Bruce Sands, MD, MS, Dr. Burrill B. Crohn Professor of Medicine at the Icahn School of Medicine, and Chief, Division of the Dr. Henry D. Janowitz Division of Gastroenterology at Mount Sinai Health System. "These subgroup analyses show that the outcomes observed with TREMFYA were consistent across clinically important patient populations, further strengthening the evidence supporting its use in this difficult to treat patient population."
Addressing an important need in Crohn's disease
Perianal fistula affects nearly
"Johnson & Johnson has a longstanding commitment to advancing the science of inflammatory bowel disease, including for patients living with some of its most complex manifestations," said David M. Lee, M.D., Ph.D., Global Immunology Therapeutic Area Head, Johnson & Johnson. "FUZION was designed to generate rigorous evidence specifically in Crohn's disease with perianal fistula, helping us deepen our understanding of how TREMFYA can address an area of unmet need."
TREMFYA is the only approved dual-acting monoclonal antibody in inflammatory bowel disease (IBD) that blocks IL-23 while also binding to CD64, a receptor on cells that produce IL-23. IL-23 is a cytokine secreted by activated monocyte/macrophages and dendritic cells that is known to be a driver of immune-mediated diseases including UC. Findings are based on in vitro studies.45678
Dr. Bruce Sands is a paid consultant for Johnson & Johnson. He has not been compensated for any media work.
For a full list of all Johnson & Johnson data being presented at ACG visit: https://www.jnj.com/innovativemedicine/immunology/gastroenterology.
Editor's notes:
a. Combined fistula remission was defined as complete closure of all external fistula openings with no drainage, without development of new fistulas, and absence of underlying fluid collections on MRI.
About the FUZION study (NCT05347095)
FUZION is a randomized, placebo-controlled, double-blind, multicenter, Phase 3 study designed to evaluate the efficacy and safety of TREMFYA in adults with Crohn's disease with perianal fistula. Patients enrolled in the study had one or more active draining perianal fistulas confirmed by blinded central MRI review, CD Activity Index [CDAI] <350, and inadequate response to oral corticosteroids, azathioprine, 6-mercaptopurine, methotrexate, or up to 2 advanced therapy classes. Patients were randomized 2:2:1 to receive TREMFYA 200 mg intravenous (IV) induction at Weeks 0, 4, 8 weeks followed by TREMFYA 100 mg subcutaneous (SC) induction every 8 weeks (q8w); or TREMFYA 200 mg IV infusion in at Weeks 0, 4, 8 weeks followed by TREMFYA 200 mg SC every 4 weeks (q4w); or placebo.9
About Crohn's disease
Crohn's disease is one of the two main forms of inflammatory bowel disease, which affects an estimated three million Americans and an estimated four million people across
About TREMFYA (guselkumab)
Developed by Johnson & Johnson, TREMFYA is the first fully-human, dual-acting monoclonal antibody designed to neutralize inflammation at the cellular source by blocking IL-23 and binding to CD64 (a receptor on cells that produce IL-23). Findings for the dual-acting mechanism are limited to in vitro studies that demonstrate TREMFYA binds to CD64, which is expressed on the surface of IL-23 producing cells in an inflammatory monocyte model. The clinical significance of this finding is not known.
TREMFYA is a prescription medicine approved in the
- adults and children 6 years and older who also weigh at least 88
pounds (40 kg) with moderate to severe plaque psoriasis who may benefit from taking injections or pills (systemic therapy) or phototherapy (treatment using ultraviolet or UV light). - adults and children 6 years and older who also weigh at least 88
pounds (40 kg) with active psoriatic arthritis. - adults with moderately to severely active ulcerative colitis.
- adults with moderately to severely active Crohn's disease.
TREMFYA is approved in
The manufacturer for TREMFYA is Janssen Biotech, Inc.
Johnson & Johnson maintains exclusive worldwide marketing rights to TREMFYA. For more information, visit: www.tremfya.com.
TREMFYA IMPORTANT SAFETY INFORMATION
What is the most important information I should know about TREMFYA?
TREMFYA is a prescription medicine that may cause serious side effects, including:
- Serious Allergic Reactions. Stop using TREMFYA and get emergency medical help right away if you develop any of the following symptoms of a serious allergic reaction:
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o fainting, dizziness, feeling lightheaded (low blood pressure) o swelling of your face, eyelids, lips, mouth, tongue or throat |
o trouble breathing or throat tightness o chest tightness o skin rash, hives o itching |
- Infections. TREMFYA may lower the ability of your immune system to fight infections and may increase your risk of infections. Your healthcare provider should check you for infections and tuberculosis (TB) before starting treatment with TREMFYA and may treat you for TB before you begin treatment with TREMFYA if you have a history of TB or have active TB. Your healthcare provider should watch you closely for signs and symptoms of TB during and after treatment with TREMFYA.
Tell your healthcare provider right away if you have an infection or have symptoms of an infection, including:
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o fever, sweats, or chills o muscle aches o weight loss o cough o warm, red, or painful skin or sores on your body different from your psoriasis |
o diarrhea or stomach pain o shortness of breath o blood in your phlegm (mucus) o burning when you urinate or urinating more often than normal |
- Liver problems. With the treatment of Crohn's disease or ulcerative colitis, your healthcare provider will do blood tests to check your liver before and during treatment with TREMFYA. Your healthcare provider may stop treatment with TREMFYA if you develop liver problems. Tell your healthcare provider right away if you notice any of the following symptoms:
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o unexplained rash o vomiting o tiredness (fatigue) o yellowing of the skin or the whites of your eyes |
o nausea o stomach pain (abdominal) o loss of appetite o dark urine |
Do not use TREMFYA if you have had a serious allergic reaction to guselkumab or any of the ingredients in TREMFYA.
Before using TREMFYA, tell your healthcare provider about all of your medical conditions, including if you:
- have any of the conditions or symptoms listed in the section "What is the most important information I should know about TREMFYA?"
- have an infection that does not go away or that keeps coming back.
- have TB or have been in close contact with someone with TB.
- have recently received or are scheduled to receive an immunization (vaccine). You should avoid receiving live vaccines during treatment with TREMFYA.
- are pregnant or plan to become pregnant. It is not known if TREMFYA can harm your unborn baby.
Pregnancy Registry: If you become pregnant during treatment with TREMFYA, talk to your healthcare provider about registering in the pregnancy exposure registry for TREMFYA. You can enroll by visiting www.mothertobaby.org/ongoing-study/tremfya-guselkumab, by calling 1-877-311-8972, or emailing MotherToBaby@health.ucsd.edu. The purpose of this registry is to collect information about the safety of TREMFYA during pregnancy. - are breastfeeding or plan to breastfeed. It is not known if TREMFYA passes into your breast milk.
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
What are the possible side effects of TREMFYA?
TREMFYA may cause serious side effects. See "What is the most important information I should know about TREMFYA?"
The most common side effects of TREMFYA include: respiratory tract infections, headache, injection site reactions, joint pain (arthralgia), diarrhea, stomach flu (gastroenteritis), fungal skin infections, herpes simplex infections, stomach pain, and bronchitis.
These are not all the possible side effects of TREMFYA. Call your doctor for medical advice about side effects.
Use TREMFYA exactly as your healthcare provider tells you to use it.
Please read the full Prescribing Information, including Medication Guide, for TREMFYA and discuss any questions that you have with your doctor.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
Dosage Forms and Strengths: TREMFYA is available as 100 mg/mL and 200 mg/2mL for subcutaneous injection and as a 200 mg/20 mL (10 mg/mL) single dose vial for intravenous infusion.
About Johnson & Johnson
At Johnson & Johnson, we believe health is everything. Our strength in healthcare innovation empowers us to build a world where complex diseases are prevented, treated, and cured, where treatments are smarter and less invasive, and solutions are personal. Through our expertise in Innovative Medicine and MedTech, we are uniquely positioned to innovate across the full spectrum of healthcare solutions today to deliver the breakthroughs of tomorrow, and profoundly impact health for humanity.
Learn more at https://www.jnj.com/ or at www.innovativemedicine.jnj.com
Follow us at @JNJInnovMed.
Cautions Concerning Forward-Looking Statements
This press release contains "forward-looking statements" as defined in the Private Securities Litigation Reform Act of 1995 related to TREMFYA. The reader is cautioned not to rely on these forward-looking statements. These statements are based on current expectations of future events. If underlying assumptions prove inaccurate or known or unknown risks or uncertainties materialize, actual results could vary materially from the expectations and projections of Johnson & Johnson. Risks and uncertainties include, but are not limited to: competition, including technological advances, new products and patents attained by competitors; uncertainty of commercial success for new products; the ability of the company to successfully execute strategic plans; impact of business combinations and divestitures; challenges to patents; changes in behavior and spending patterns or financial distress of purchasers of health care products and services; and global health care reforms and trends toward health care cost containment. A further list and descriptions of these risks, uncertainties and other factors can be found in Johnson & Johnson's most recent Annual Report on Form 10-K, including in the sections captioned "Cautionary Note Regarding Forward-Looking Statements" and "Item 1A. Risk Factors," and in Johnson & Johnson's subsequent Quarterly Reports on Form 10-Q and other filings with the Securities and Exchange Commission. Copies of these filings are available online at www.sec.gov, www.jnj.com, www.investor.jnj.com or on request from Johnson & Johnson. Johnson & Johnson does not undertake to update any forward-looking statement as a result of new information or future events or developments.
REFERENCES
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2 Sulak A., et al. Where Are We and Where to Next?—The Future of Perianal Crohn's Disease Management, Journal of Clinical Medicine, Volume 12, Issue 19, October 2023, 6379, https://doi.org/10.3390/jcm12196379. |
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3 Spinelli A, Yanai H, Girardi P, Milicevic S, Carvello M, Maroli A, Avedano L. The Impact of Crohn's Perianal Fistula on Quality of Life: Results of an International Patient Survey. Crohns Colitis 360. 2023 Jul 25;5(3):otad036. doi: 10.1093/crocol/otad036. PMID: 37529012; PMCID: PMC10390083. |
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4 Atreya R, Abreu MT, Krueger JG, et al. Guselkumab, an IL-23p19 subunit-specific monoclonal antibody, binds CD64+ myeloid cells and potentially neutralizes IL-23 produced from the same cells. Poster presented at: 18th Congress of the European Crohn's and Colitis Organization (ECCO); March 1-4, 2023; |
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5 Kreuger JG, Eyerich K, Kuchroo VK. Il-23 past, present, and future: a roadmap to advancing IL-23 science and therapy. Front Immunol. 2024; 15:1331217. doi:10.3389/fimmu.2024.1331217. |
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6 TREMFYA® [Prescribing Information]. |
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7 Skyrizi® [Prescribing Information]. |
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8 Omvoh™ [Prescribing Information]. |
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9 National Institutes of Health: Clinicaltrials.gov. A Study of Guselkumab in Participants With Fistulizing, Perianal Crohn's Disease (FUZION CD). Identifier: NCT05347095. https://clinicaltrials.gov/study/NCT05347095?tab=researcher. Accessed March 2026. |
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10 Crohn's & Colitis Foundation. Overview of Crohn's disease. Available at: https://www.crohnscolitisfoundation.org/what-is-crohns-disease/overview. Accessed August 2026. |
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11 Ng SC, et al. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. The Lancet. 2017;390:2769-78. |
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12 Crohn's & Colitis Foundation. What is Crohn's disease? Available at: https://www.crohnscolitisfoundation.org/what-is-crohns-disease/causes. Accessed August 2026. |
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13 Crohn's & Colitis Foundation. Signs and symptoms of Crohn's disease. Available at https://www.crohnscolitisfoundation.org/patientsandcaregivers/what-is-crohns-disease/symptoms. Accessed August 2026. |
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SOURCE Johnson & Johnson Innovative Medicine
FAQ
AI-generated questions and answers. How Rhea-AI works. Not financial advice.
What were the overall TREMFYA remission results in Johnson & Johnson's FUZION trial?
At Week 24, combined fistula remission occurred in 28% of patients receiving TREMFYA 100 mg every eight weeks and 27% receiving 200 mg every four weeks, compared with 10% receiving placebo. These previously reported overall results provide the context for the new prespecified subgroup analyses.
How did TREMFYA perform in FUZION patients with prior biologic exposure?
Patients with prior biologic exposure achieved Week 24 combined fistula remission rates of 21% with TREMFYA 100 mg every eight weeks and 29% with 200 mg every four weeks, versus 5% with placebo.
Which patients were eligible for Johnson & Johnson's FUZION trial?
FUZION enrolled adults with Crohn's disease who had one or more active draining perianal fistulas confirmed by blinded central MRI review and a Crohn's Disease Activity Index below 350. Patients also had an inadequate response to oral corticosteroids, azathioprine, 6-mercaptopurine, methotrexate, or up to 2 advanced therapy classes.
How were TREMFYA treatment groups assigned in Johnson & Johnson's FUZION trial?
Patients were randomized 2:2:1 to two TREMFYA groups or placebo in a double-blind study. Both TREMFYA groups received 200 mg intravenously at Weeks 0, 4 and 8, followed by injections under the skin of either 100 mg every eight weeks or 200 mg every four weeks.