Monday, 25 Sep 2017

You are here

Tildrakizumab, an IL-23 Inhibitor, is Successful in Plaque Psoriasis

Therapeutic options for cutaneous psoriasis (and psoriatic arthritis as well) are rapidly expanding.  Lancet has published the impressive results of two phase III trials of tildrakizumab, a IgG1 antibody against interleukin 23 p19, in patients with active chronic plaque psoriasis.

Two large randomised controlled studies, reSURFACE 1 and reSURFACE 2 enrolled  2062 adults with moderate-to-severe chronic plaque psoriasis with ≥10% body surface area involvement.

In reSURFACE 1, patients received tildrakizumab 200 mg, tildrakizumab 100 mg, or placebo and in reSURFACE 2 they received tildrakizumab 200 mg, tildrakizumab 100 mg, placebo, or etanercept 50 mg given subcutaneously at weeks 0 and 4 during part 1 of the studies and at week 16 during part 2.

In reSURFACE 1, at week 12, a PASI75 was acheived in 62% in the 200 mg group and 64% in the 100 mg group compared with 6% in the placebo group (p<0·0001 vs placebo).

In reSURFACE 2, a PASI75 was seen 66% in the 200 mg group, 61% in the 100 mg group, and 48% in the etanercept group compared with 6% in the placebo group.

Serious adverse events were similar and low in all groups in both trials, with only one death in reSURFACE 2.

These 2 large trials affirm the efficacy of tildrakizumab (an IL-23 inhibitor) in psoriasis and that responses were superior to placebo and etanercept in moderate-to-severe chronic plaque psoriasis patients. 

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Psoriasis Doubles Mortality Risk

Noe and colleagues have reported in the Journal of Investigative Dermatology that by estimating the extent of skin involvement in psoriasis (%BSA) they may assess future mortality risk. 

Psoriasis patients with 10% or more body surface area (BSA) involvement nearly doubled their risk of early death than those without the disease.

IV Golimumab Shines in Psoriatic Arthritis

Golimumab (GOL) is one of five marketed TNF inhibitors (TNFi) that is FDA approved for use in psoriatic arthritis (PsA). PsA approval was based on a 259 patient, randomized, controlled trial wherein GOL treated patients exhibited at week 24 ACR20/50/70 response of 52%, 32%, and 19%, respectively.

Therapeutic Update: 5 Questions on FDA Hearing for Tofacitinib in PsA

In this Therapeutic Update, Drs. Mease, Gibofsky and Cush answer five questions regarding the August 3rd FDA Arthritis Advisory Committee meeting that reviewed the potential approval of tofacitinib (Xeljanz) in patients with active psoriatic arthritis. The panel was nearly unanimous (10-1) in favor of the efficacy and safety profile of of tofacitinib, and similarly voted 10-1 to approve this drug for use in PsA. Final decisions on these recommendations from the AAC panel will be made at a later date by the FDA. 

Psoriatic Arthritis Patients with Comorbidities have Worse Disease and Poor Responses

A population-based cohort study shows that comorbidities in psoriatic arthritis patients (PsA) were associated with higher disease activity, shorter persistence and reduced clinical response to TNF inhibitors (TNFi). 

FDA Arthritis Advisory Panel Endorses Tofacitinib Approval for Psoriatic Arthritis

On Thursday, August 3, the FDA Arthritis Advisory Committee (AAC) met to consider tofacitinib for use in patients with psoriatic arthritis. The panel voted 10-1 in favor of approval.