Tildrakizumab

Indications

Tildrakizumab is used for: Plaque Psoriasis

Adult Dose

Plaque Psoriasis Indicated for moderate-to-severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy 100 mg SC at Weeks 0, 4, and q12Weeks thereafter

Child Dose

<18 years: Safety and efficacy not established

Renal Dose

Administration

Contra Indications

Hypersensitivity reaction to tildrakizumab or to any of the excipients

Precautions

In clinical trials, cases of angioedema and urticaria occurred; if serious hypersensitivity reaction occurs, discontinue treatment immediately and initiate appropriate therapy (see Contraindications) There is a slight increased risk of infection with patients treated with tildrakizumab in clinical trials; patients with active infections or history of recurrent infections were not included in clinical trials; consider the risks and benefits before prescribing Immunizations Before initiating therapy, consider completion of all age appropriate immunizations according to current immunization guidelines No data are available on the response to live or inactive vaccines Avoid use of live vaccines Pretreatment evaluation for tuberculosis Evaluate patients for TB infection before initiating treatment Initiate treatment of latent TB before administering tildrakizumab; monitor for signs and symptoms of active TB during and after tildrakizumab Consider anti-TB therapy before initiating treatment in patients with a past history of latent or active TB in whom an adequate course of treatment cannot be confirmed; do not administer to patients with active TB infection

Pregnancy-Lactation

Pregnancy Data are limited regarding use in pregnant women and are insufficient to inform a drug associated risk of adverse developmental outcomes Human IgG is known to cross the placental barrier; therefore, tildrakizumab may be transferred from the mother to the fetus Lactation No data are available on the presence of tildrakizumab in human milk, the effects on the breastfed infant, or the effects on milk production Human IgG is known to be present in human milk Tildrakizumab was detected in the milk of monkeys

Interactions

Adverse Effects

Side effects of Tildrakizumab : >10% Upper respiratory infections (14%) 1-10% Injection site reactions (3%) Diarrhea (2%)

Mechanism of Action

Humanized IgG1/k monoclonal antibody that selectively binds to the p19 subunit of interleukin-23 (IL-23) and inhibits its interaction with the IL-23 receptor IL-23 is a naturally occurring cytokine that is involved in inflammatory and immune responses Tildrakizumab inhibits the release of proinflammatory cytokines and chemokines