Drug updated on 5/17/2024

Dosage FormInjectable (subcutaneous; 100 mg/mL)
Drug ClassInterleukin-23 antagonists
Ongoing and
Completed Studies


  • Indicated for the treatment of adults with moderate-to-severe plaque psoriasis who are candidates for systemic therapy or phototherapy.

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  • Tildrakizumab-asmn (Ilumya) is indicated for the treatment of adults with moderate-to-severe plaque psoriasis and has demonstrated significant efficacy, notably in achieving PASI 90 scores. It is ranked below high-efficacy treatments such as ixekizumab and risankizumab but offers long-term stability in its efficacy-safety balance.
  • A comprehensive review of 15 systematic reviews/meta-analyses was conducted to assess the safety and effectiveness of tildrakizumab compared to other systemic treatments for moderate-to-severe plaque psoriasis.
  • In the treatment of nail psoriasis, tildrakizumab has shown promising outcomes similar to other IL-23 inhibitors; however, direct comparisons with IL-17 inhibitors or TNF-alpha inhibitors are limited.
  • The safety profile of tildrakizumab is consistent with common adverse events associated with biologic treatments for psoriatic diseases, such as nasopharyngitis and upper respiratory infections. Serious adverse events related to this medication do not significantly differ from placebo effects in most studies.
  • Anti-drug antibodies (ADAs) have been observed in patients treated with IL-23 inhibitors including tildrakizumab; however, their clinical significance seems minimal due to a low incidence rate of neutralizing antibodies without any direct correlation reducing its efficacy in psoriasis treatment.
  • Subgroup analyses suggest that patients naive to biological treatment or those with varying degrees of baseline disease severity can benefit significantly from using this medication. However, further exploration through comparative studies is necessary, especially when considering patient characteristics such as body weight over 90 kg or conditions like PsA.
  • Tildrakizumab's favorable safety profile suggests it could be a valuable stratification tool within personalized medicine, specifically targeting subsets suffering from moderate-to-severe plaque psoriasis without major comorbid PsA conditions.
  • Despite the promising results, there is a need for head-to-head trials that extend beyond placebo comparisons to fully integrate indirect comparisons with contemporary biologics and systemic treatments.

Product Monograph / Prescribing Information

Document TitleYearSource
Ilumya (tildrakizumab-asmn) Prescribing Information.2020Sun Pharmaceutical Industries, Inc., Cranbury, NJ

Systematic Reviews / Meta-Analyses

Document TitleYearSource
Efficacy and safety of nail psoriasis targeted therapies: a systematic review.2023American Journal of Clinical Dermatology
Systemic pharmacological treatments for chronic plaque psoriasis: a network meta-analysis. 2023Cochrane Database of Systematic Reviews
Efficacy and safety of IL-23 inhibitors in the treatment of psoriatic arthritis: a meta-analysis based on randomized controlled trials. 2023Immunologic Research
Adverse effects of anti-interleukin-23 agents employed in patients with psoriasis: a systematic review.2022Dermatology
Anti-drug antibodies of IL-23 inhibitors for psoriasis: a systematic review.2022Journal of the European Academy of Dermatology and Venereology
Targeted systemic therapies for psoriatic arthritis: a systematic review and comparative synthesis of short-term articular, dermatological, enthesitis and dactylitis outcomes.2022RMD Open
Comparative efficacy and safety of biologics in moderate to severe plaque psoriasis: a multiple-treatments meta-analysis.2021Journal of the German Society of Dermatology
Comparative efficacy and relative ranking of biologics and oral therapies for moderate-to-severe plaque psoriasis: a network meta-analysis. 2021Dermatology and Therapy
Comparative safety and benefit-risk profile of biologics and oral treatment for moderate-to-severe plaque psoriasis: a network meta-analysis of clinical trial data.2021Journal of the American Academy of Dermatology
Therapeutic update of biologics and small molecules for scalp psoriasis: a systematic review.2021Dermatologic Therapy
A systematic review with network meta-analysis of the available biologic therapies for psoriatic disease domains. 2021Frontiers in Medicine
A systematic literature review and bucher indirect comparison: tildrakizumab versus guselkumab.2020Journal of Health Economics and Outcomes Research
Systematic review on rapidity of onset of action for interleukin-17 and interleukin-23 inhibitors for psoriasis.2020Journal of the European Academy of Dermatology and Venereology
Tildrakizumab: an evidence-based review of its use in the treatment of moderate-to-severe chronic plaque psoriasis.2020Therapeutics and Clinical Risk Management
Short-term efficacy and safety of IL-17, IL-12/23, and IL-23 inhibitors brodalumab, secukinumab, ixekizumab, ustekinumab, guselkumab, tildrakizumab, and risankizumab for the treatment of moderate to severe plaque psoriasis: a systematic review and network meta-analysis of randomized controlled trials.2019Journal of Immunology Research

Clinical Practice Guidelines