Summary

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• Ilumya (tildrakizumab-asmn) is indicated for the treatment of adults with moderate-to-severe plaque psoriasis who are candidates for systemic therapy or phototherapy.
• This summary is based on the review of 15 systematic review(s)/meta-analysis(es). ^[1-15]
• Tildrakizumab demonstrated statistically significant improvements in nail psoriasis outcomes compared to placebo or baseline values, with notable efficacy at weeks 10-16, 20-26, and up to 60 weeks. Comparisons suggest ixekizumab and brodalumab show greater efficacy than other comparators like adalimumab and ustekinumab.
• In treating plaque psoriasis, Tildrakizumab improved PASI 90 response rates but was less effective than other drugs, including infliximab, bimekizumab, ixekizumab, and risankizumab. IL-17 inhibitors and some IL-23 inhibitors showed higher efficacy in achieving PASI 90.
• Tildrakizumab showed a significantly higher ACR20 response rate in psoriatic arthritis compared to placebo (RR = 1.74, 95% CI: 1.57-1.92; P < 0.001). IL-23 inhibitors like guselkumab and risankizumab demonstrated similar effectiveness.
• Higher efficacy of Tildrakizumab (200 mg) was observed in patients with a body weight ≥90 kg.
• Tildrakizumab's safety profile is consistent with known data, with common adverse events including nasopharyngitis, upper respiratory tract infections, headache, and diarrhea.
• Tildrakizumab did not show significant differences in the risk of SAEs compared to placebo in most studies. Methotrexate demonstrated a lower risk of SAEs compared to most interventions, including Tildrakizumab.
• Tildrakizumab had higher rates of nasopharyngitis, headache, upper respiratory tract infections, and back pain. Anti-drug antibodies were observed in 6.51-18% of cases, with neutralizing antibodies in 2.5-3.2%, correlating with reduced clinical response and higher incidence of injection site reactions. Discontinuations due to adverse events were lower with Tildrakizumab compared to other biologics.
• The studies included adults over 18 years with an average age of 44.5 years and 67.2% male participants; higher efficacy of Tildrakizumab (200 mg) was observed in patients with body weight ≥90 kg; no significant differences in ACR response among patients with or without prior biological therapy exposure.