tildrakizumab: clinical use

Prescribing considerations

• Initiate and supervise treatment through a clinician experienced in diagnosing and treating plaque psoriasis.
• Review chronic, recurrent or recent serious infections before starting.
• Consider appropriate immunisations before treatment and avoid live vaccines during treatment.
• Combination safety and efficacy with immunosuppressants, biological therapies or phototherapy are not established.
• Record the product name and batch number for traceability.

Contraindications and cautions

• Hypersensitivity to tildrakizumab or an excipient.
• Clinically important active infection, including active tuberculosis.

Monitoring

• Evaluate for tuberculosis before treatment and remain alert for active tuberculosis during and after therapy.
• Monitor for clinically important infection; withhold administration during a serious infection until it resolves.
• Discontinue immediately if a serious hypersensitivity reaction occurs.
• Review clinical response and maintain specialist follow-up.

Clinical pharmacology

A humanised IgG1/k monoclonal antibody targeting IL-23 p19. It undergoes general protein catabolism rather than CYP metabolism or renal or hepatic elimination; clinically relevant effects on CYP-metabolised medicines are not expected.

Formulation and product differences

• Sterile solution in a single-use pre-filled syringe with a passive needle-safety device.
• The solution should be clear to slightly opalescent and colourless to slightly yellow.
• Contains polysorbate 80, which may cause allergic reactions.

Injection

Route: Parenteral

Strengths: 100 mg, 200 mg