Introduction

Tildrakizumab (trade name EU: Ilumetri, U.S.: Ilumya) has been approved in Germany since September 2018 for the systemic treatment of moderate to severe plaque psoriasis in adults.

Psoriasis is a non-contagious inflammatory skin disease. The symptoms usually include clearly defined red patches (called "plaques"), scaly skin and often itching too. They come and go in bouts: The skin can get better on its own, but it may also suddenly get worse. Psoriasis is a chronic (long-lasting) condition that currently has no cure.

It is usually treated with creams or ointments. Treatment with UV light (phototherapy) is an option for people with severe psoriasis. There are also medications designed to slow down or stop the inflammatory process in different ways. They can either be taken as tablets or injected into the bloodstream. Treatment with drugs that have an effect on the entire body is called systemic treatment.

The antibody tildrakizumab is used to decrease the inflammation in the skin by inhibiting several chemical messengers.

Application

Tildrakizumab is available in ready-to-use syringes at a dose of 100 mg. It is injected into the skin (subcutaneously).

After the initial injection, the treatment is repeated one month later. Subsequent injections are given every three months. Patients can also inject themselves after being instructed how to do so by a doctor.

If there is no improvement after about 7 months, doctors usually recommend stopping the treatment.

Other treatments

For people with moderate to severe plaque psoriasis who are able to have systemic treatment for the first time, the drugs adalimumab, ciclosporin, ixekizumab, methotrexate or secukinumab are available. Phototherapy is also an option.

People who have already had systemic treatment – but it didn’t work well enough – can also use adalimumab, ixekizumab or secukinumab, or infliximab or ustekinumab, depending on what treatment was tried before.

Assessment

In 2019, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) wanted to look into the advantages and disadvantages of tildrakizumab compared with the standard treatments for moderate to severe plaque psoriasis in adults.

But the manufacturer didn’t provide any suitable data with which to do the assessment.

More information

This information summarizes the main results of a review produced by the Institute for Quality and Efficiency in Health Care (IQWiG, Germany). The review was commissioned by the German Federal Joint Committee (G-BA) as part of the “early benefit assessment of medications.” On the basis of the review and the hearings received, the G-BA passed a resolution on the added benefit of tildrakizumab (EU: Ilumetri, U.S.: Ilumya).