Tildrakizumab: monoclonal antibody against IL-23p19 for moderate to severe psoriasis

Tildrakizumab is a monoclonal antibody that binds to the p19 subunit of interleukin (IL)-23. Studies examining affected skin in psoriatic patients showed significant changes in the cellular, cytokine and gene expression profiles of psoriatic lesions as a result of treatment with tildrakizumab, as well as significant changes in clinical measures of disease activity. These studies demonstrated significant clinical responses in psoriasis with significant improvements found in the percentage of patients achieving a Physician Global Assessment score of 0 or 1, and a 75%, 90% or 100% improvement in the Psoriasis Area and Severity index (PASI 75, PASI 90, PASI 100). These changes were accompanied by a low frequency of adverse effects. This combination of efficacy and safety led to the approval of tildrakizumab in 2018 by the U.S. Food and Drug Administration (FDA) for use in adult patients with moderate to severe psoriasis.