Tildrakizumab for treatment of moderate to severe psoriasis: an expert opinion of efficacy, safety, and use in special populations

ABSTRACT

Introduction

Tildrakizumab is a monoclonal antibody that targets the p19 subunit of IL-23, a crucial cytokine for Th17 cells. Tildrakizumab has been assessed in several Phase I, II, and III clinical trials and is approved for treatment of adults with moderate to severe plaque psoriasis who are indicated for systemic therapy.

Areas covered

The available evidence on the efficacy, safety, and use of tildrakizumab in special populations was evaluated by 14 experts who critically reviewed the current literature.

Expert opinion

Tildrakizumab has good efficacy that lasts for at least 5 years in patients with moderate to severe psoriasis, and appears to be safe and well tolerated in the long-term with no apparent dose-related differences in adverse events, a low incidence of discontinuation due to adverse events, and no evidence of increased risk of malignancies. The safety and the efficacy of tildrakizumab has also been confirmed in special populations such as those with inflammatory bowel disease, cardiovascular disease, metabolic syndrome, and advanced age. Early intervention with IL-23-inhibitors, such as tildrakizumab, may help to control symptoms and change the long-term course of the disease in patients affected by plaque psoriasis, while improving the quality of life and potentially minimizing the risk of developing comorbidities.

KEYWORDS:

• Long-term
• efficacy
• psoriasis
• real life
• safety
• special populations
• tildrakizumab

Article highlights

• Tildrakizumab is indicated for indicated for the treatment of adults with moderate to severe plaque psoriasis who are candidates for systemic therapy.

• The available literature on the efficacy, safety, and use of tildrakizumab in special populations was evaluated by 14 experts.

• Tildrakizumab has good efficacy that lasts for at least 5 years in patients with moderate to severe psoriasis.

• Tildrakizumab appears to be safe and well tolerated in the long-term.

• The safety and the efficacy of tildrakizumab have been confirmed in inflammatory bowel disease, cardiovascular disease, metabolic syndrome, and advanced age.

• Early intervention with IL-23-inhibitors, such as tildrakizumab, may help to control symptoms and improve the long-term course of plaque psoriasis.

This box summarizes key points contained in the article.

Declaration of interests

A. Chiricozzi served as advisory board member and consultant, he has received speaker’s honoraria or has participated in clinical trials for AbbVie, Almirall, Biogen, Fresenius Kabi, Leo Pharma, Lilly, Janssen, Novartis, Sanofi Genzyme and UCB Pharma. The author(s) have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This paper is not funded.