Tildrakizumab: An evidence-based review of its use in the treatment of moderate-to-severe chronic plaque psoriasis
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Tildrakizumab : An evidence-based review of its use in the treatment of moderate-to-severe chronic plaque psoriasis. / Näslund-Koch, Charlotte; Zachariae, Claus; Skov, Lone.
In: Therapeutics and Clinical Risk Management, Vol. 16, 2020, p. 889-901.Research output: Contribution to journal › Review › Research › peer-review
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TY - JOUR
T1 - Tildrakizumab
T2 - An evidence-based review of its use in the treatment of moderate-to-severe chronic plaque psoriasis
AU - Näslund-Koch, Charlotte
AU - Zachariae, Claus
AU - Skov, Lone
PY - 2020
Y1 - 2020
N2 - Psoriasis is a common immune-mediated chronic inflammatory disease, and observations have pointed toward the IL-23/Th17 cell axis as having a key role in the pathogenesis of psoriasis. This new immunological understanding of the pathogenesis has been translated into targeted and highly effective biologic therapies. Tildrakizumab is a humanized IgG1/k monoclonal antibody targeting the p19 unit of IL-23 and has been registered for the treatment of patients with moderate-to-severe chronic plaque psoriasis in adults since 2018. This review provides an overview of the efficacy and safety of tildrakizumab, focusing on the results from clinical trials. In both Phase II and III trials, tildrakizumab 100 and 200 mg was significantly more efficacious than both placebo and etanercept at week 12. The effect of tildrakizumab continued to increase until week 28. Long-term follow-up showed high levels of efficacy for up to 3 years. Despite no difference between 100 and 200 mg in Phase III studies, subgroup analyses showed better efficacy when treated with 200 mg in patients with bodyweight ≥90 kg. The overall drug safety was good, and besides discrete higher incidence of nasopharyngitis, the conducted clinical trials show that tildrakizumab was very well tolerated without any safety concerns. Compared to other IL23p19 inhibitors, tildrakizumab seemed to have slightly lower efficacy. However, to determine its position in the treatment algorithm of psoriasis, head-to-head trials with other IL-17, IL-12/23, and IL-23 inhibitors and long-term real-world data are required.
AB - Psoriasis is a common immune-mediated chronic inflammatory disease, and observations have pointed toward the IL-23/Th17 cell axis as having a key role in the pathogenesis of psoriasis. This new immunological understanding of the pathogenesis has been translated into targeted and highly effective biologic therapies. Tildrakizumab is a humanized IgG1/k monoclonal antibody targeting the p19 unit of IL-23 and has been registered for the treatment of patients with moderate-to-severe chronic plaque psoriasis in adults since 2018. This review provides an overview of the efficacy and safety of tildrakizumab, focusing on the results from clinical trials. In both Phase II and III trials, tildrakizumab 100 and 200 mg was significantly more efficacious than both placebo and etanercept at week 12. The effect of tildrakizumab continued to increase until week 28. Long-term follow-up showed high levels of efficacy for up to 3 years. Despite no difference between 100 and 200 mg in Phase III studies, subgroup analyses showed better efficacy when treated with 200 mg in patients with bodyweight ≥90 kg. The overall drug safety was good, and besides discrete higher incidence of nasopharyngitis, the conducted clinical trials show that tildrakizumab was very well tolerated without any safety concerns. Compared to other IL23p19 inhibitors, tildrakizumab seemed to have slightly lower efficacy. However, to determine its position in the treatment algorithm of psoriasis, head-to-head trials with other IL-17, IL-12/23, and IL-23 inhibitors and long-term real-world data are required.
KW - Biologics
KW - Efficacy
KW - IL-23p19
KW - Psoriasis
KW - Safety
KW - Tildrakizumab
U2 - 10.2147/TCRM.S258704
DO - 10.2147/TCRM.S258704
M3 - Review
C2 - 33061394
AN - SCOPUS:85091570766
VL - 16
SP - 889
EP - 901
JO - Therapeutics and Clinical Risk Management (Print)
JF - Therapeutics and Clinical Risk Management (Print)
SN - 1176-6336
ER -
ID: 255842316