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Ilumetri (also referred to by its generic name, Tildrakizumab) is a biologic medication that is used to treat severe psoriasis.
How does Ilumetri work?
Ilumetri blocks the activity of interleukin 23 (IL-23), a chemical ‘messenger’ in the immune system that signals other cells to cause inflammation. In people with psoriasis or psoriatic arthritis, the immune system is overactive and creates too much inflammation, which leads to the development of psoriasis symptoms. Ilumetri is very precise and binds to a specific part of the IL-23 messenger, called p19. This then blocks IL-23 from sending out the inflammation signals and processes, preventing some of the inflammation from occurring and leading to an improvement in psoriasis for some people who take it.
Who is Ilumetri for?
Ilumetri is for adults with moderate to severe psoriasis who have not had a good response from, or cannot take or tolerate other systemic treatments including ciclosporin, methotrexate or PUVA. You will usually need to have tried these treatments before you can be offered Ilumetri. If you have tried these treatments but they did not work, Ilumetri might be an option for you.
How is Ilumetri used?
Ilumetri is taken as an injection under the skin via a pre-filled syringe. Most people will be trained by a nurse to give the injection to themselves. The second dose is taken four weeks after the first, but after that Ilumetri is usually taken every 12 weeks thereafter.
People taking Ilumetri will have regular blood tests every three to six months – usually carried out by Dermatology nurses, or by their own GP, to monitor for infections or other possible effects of the treatment. People taking Ilumetri are more at risk of infections and so should have an annual flu and pneumococcal vaccination.
However, not all vaccinations are safe in people taking Ilumetri and ‘live’ vaccinations should be avoided for four weeks before treatment, during treatment and for 12 months afterwards. Check with a doctor, nurse or pharmacist before having any vaccinations or taking other medication if you are not sure.
Who should not take Ilumetri?
- People with active infections should not start Ilumetri. Because of the effect Ilumetri has on the immune system, you will be monitored for infections throughout treatment, and you will be tested for latent (hidden) TB before starting treatment.
- In most cases, pregnant women should not be treated with Ilumetri and women should not breastfeed during treatment with Ilumetri. Women should avoid falling pregnant for seventeen weeks after treatment has stopped.
- Ilumetri is not suitable for use in children.
What are the side effects of Ilumetri?
As with all medications, some side effects are possible when taking Ilumetri. It is important to remember that not every person taking a medication will get all, or even any, of the possible side effects listed. Many side effects of Ilumetri are mild and do not cause most people to stop taking it. Ilumetri is a new treatment and, as such, this side effect data comes from clinical trials, but will be updated as more ‘real-world’ experience with the treatment is collected.
The most common side effects of Ilumetri are upper respiratory tract infections, headache, diarrhoea, nausea, stomach flu (also known as gastroenteritis), back pain and injection site reactions (such as redness or burning of the skin where the treatment is injected). Because Ilumetri works by suppressing part of the activity in the immune system, it can make people taking it more prone to infections than they would usually be. If a serious infection occurs, a doctor will most likely stop Ilumetri.
Although side effects are possible with this, and any treatment, it is important to remember that people taking Ilumetri have regular blood tests to check for health issues. If you are worried about the side effects of Ilumetri, you should discuss these with your doctor.
How long will Ilumetri take to work?
It can take a number of weeks before a person’s psoriasis improves on Ilumetri. If considerable improvement is not seen in 28 weeks, treatment with Ilumetri will be stopped. If this happens, a Dermatologist should discuss the next available options with you – there are a number of other biologic or systemic treatments that can be tried if Ilumetri does not work.
How safe and effective is Ilumetri?
Ilumetri is a new medication to treat moderate to severe psoriasis that was approved for use in England and Wales in April 2019 and Scotland in August 2019. ‘Real-world’ (i.e. Non-clinical trial) safety and effectiveness data is being collected by a long-running study, the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR). It is recommended that all people taking biologic treatments for their psoriasis should be asked for their information to be included in this register.
The information on this page is also available in our Ilumetri (Tildrakizumab) information sheet.