title: Tildrakizumab for treating psoriasis.
abstract: Agents that block inflammatory pathways other than tumor necrosis factor (TNF) have represented new options for treating psoriasis in recent years. IL-23 is involved in regulating Th17 cells and is a potent activator of keratinocyte proliferation. Targeting IL-23p19 alone may be a promising treatment approach in patients with moderate-to-severe chronic plaque psoriasis, with a downregulation of Th17 and Th22 cell responses, while IL-12 blockade is not required to achieve efficacy in these patients. Areas covered: The authors review and provide an update on tildrakizumab, a humanized IgG1 monoclonal antibody that blocks the p19 subunit of IL-23. Expert opinion: Total skin clearance is an important treatment goal that has both measurable and clinically meaningful benefits. Meeting patient needs about total clearance, IL-23p19 inhibitors will obtain a specific position in the crowded psoriasis market. On the other hand, PASI 75 and PASI 90 response achieved by tildrakizumab in the phase II and III trials are less than the response achieved by the IL-17A inhibitors and other p19 competitors, possibly due to a less intensive dosing regimen, although direct comparisons cannot be made without a head-to-head randomized clinical trial. The main advantage of tildrakizumab is that it is dosed in a maintenance regimen of 12 weeks, and similar to ustekinumab, this is likely to encourage adherence and aid persistence to the drug.
authors.affiliation: a Department of Dermatology , University of Rome "Tor Vergata," , Rome , Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Galluzzo
authors.affiliation: a Department of Dermatology , University of Rome "Tor Vergata," , Rome , Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: D'adamio
authors.affiliation: a Department of Dermatology , University of Rome "Tor Vergata," , Rome , Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Bianchi
authors.affiliation: a Department of Dermatology , University of Rome "Tor Vergata," , Rome , Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Talamonti
mesh_terms: D000818:Animals; D000911:Antibodies, Monoclonal / Q000494:pharmacology / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D049109:Cell Proliferation / Q000187:drug effects / Q000502:physiology; D002986:Clinical Trials as Topic / Q000379:methods; D006801:Humans; D053759:Interleukin-23 / Q000037:antagonists & inhibitors* / Q000276:immunology; D011565:Psoriasis / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D012867:Skin / Q000187:drug effects / Q000276:immunology / Q000473:pathology; D058504:Th17 Cells / Q000187:drug effects / Q000276:immunology; D016896:Treatment Outcome; D000069549:Ustekinumab / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D053759:Interleukin-23; C000598434:tildrakizumab; D000069549:Ustekinumab
keywords: IL23 inhibitors; PASI 100; Tildrakizumab; anti-IL23p19; monoclonal antibodies; psoriasis