Tildrakizumab for Treatment of Moderate-to-Severe Plaque Psoriasis: Could Sun Pharma’s ‘Ilumya’ be a Better Option?

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Tildrakizumab is being marketed by Sun Pharma under the trade name Ilumya, and has been approved by FDA in March 2018 after analysis of data from Phase III multi-centre, randomised, placebo-controlled clinical trials reSURFACE 1 and reSURFACE 2. Both studies achieved the primary endpoint of at least 75% of skin clearance as measured by PASI and PGA scores. The approval from European Commission and TGA, Australia came in September 2018. Based on the clinical and cost-effectiveness of Ilumya, NICE, UK has recommended the use of tildrakizumab in 2019 for the treatment of severe psoriasis.

Could Sun Pharma’s

Plaque psoriasis is an autoimmune inflammatory disease that inflicts nearly 125 million people across the world. Most common symptoms include red patchy lesions on parts of skin, including knees, elbow, scalp or lower back, that get inflamed and are itchy and painful. 80% of the people who contract the disease have mild to moderate symptoms while 20% have severe form the disease in which the plaques crack leading to bleeding and further discomfort. Psoriasis has significant social and economic implications for the patients suffering from the disease. The quality of life is impacted severely as patient’s develop depression and suicidal tendencies due to ‘normal’ people maintaining social distancing from infected ones causing them to feel ashamed and leaving them in further distress.

A wide variety of treatments are available for psoriasis depending on the severity of symptoms. It comprises of topical treatment using skin ointments, phototherapy, in which skin is exposed to UV light and systemic medication that includes chemical entities as well as biological entities such as antibodies.

The biological treatments in vogue for psoriasis include antibodies such as etanercept, adalimumab, infliximab, ustekinumab and tildrakizumab to name a few. These antibodies act by reducing inflammation by targeting the overactive cells of the host immune system. Biological treatments are often used in severe cases of psoriasis when patients do not respond to other treatments mentioned above.

Among the biological entities used for psoriasis treatment, tildrakizumab seems to be be the most effective in terms of reducing the symptoms as well as its costing. Clinical trial results have shown that tildrakizumab improves severe plaque psoriasis compared with placebo or etanercept with a marked improvement seen at 28 weeks. Moreover, tildrakizumab appears to be as effective as adalimumab and ustekinumab. With respect to costs, tildrakizumand is 18% more cost effective than adalimumab on a monthly basis leading to a significant cost reduction over a five-year period.

Tildrakizumab is being marketed by Sun Pharms under the trade name Ilumya, and has been approved by FDA in March 2018 after analysis of data from Phase III multi-centre, randomised, placebo-controlled clinical trials reSURFACE 1 and reSURFACE 2. Both studies achieved the primary endpoint of at least 75% of skin clearance as measured by PASI and PGA scores. The approval from European Commission and TGA, Australia came in September 2018. Based on the clinical and cost-effectiveness of Ilumya, NICE, UK has recommended the use of tildrakizumab in 2019 for the treatment of severe psoriasis.

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