What is Ilumya?

Ilumya (tildrakizumab-asmn) is a brand-name prescription medication that’s used to treat moderate to severe plaque psoriasis. It’s prescribed for adults who are eligible for systemic therapy (drugs given by injection or taken by mouth) or phototherapy (light therapy).

Ilumya is a type of drug called a monoclonal antibody. A monoclonal antibody is a specialized immune system protein created in a lab. These proteins target specific parts of your immune system. They’re a type of biologic therapy (drugs developed from living organisms instead of chemicals).

Ilumya comes in a single-dose prefilled syringe. A healthcare provider in your doctor’s office administers it by injecting it under your skin (subcutaneous injection).

After the first two doses, which are given four weeks apart, Ilumya is given every 12 weeks.

In clinical studies, between 55 percent and 58 percent of people who received Ilumya had minimal or cleared psoriasis symptoms after 12 weeks. More than two-thirds of people who had these results maintained them over 64 weeks.

FDA approval

Ilumya was approved by the Food and Drug Administration (FDA) in March 2018.

Ilumya generic

Ilumya is available only as a brand-name medication. It’s not currently available in generic form.

Ilumya contains the drug tildrakizumab, which is also called tildrakizumab-asmn.

Ilumya cost

As with all medications, the cost of Ilumya can vary. To find current prices for Ilumya in your area, check out GoodRx.com:

The cost you find on GoodRx.com is what you would pay without insurance. Your actual cost will depend on your insurance coverage.

Financial and insurance assistance

If you need financial support to pay for Ilumya, help is available.

Sun Pharma Global FZE, the manufacturer of Ilumya, will offer a program called Ilumya Support Lighting the Way. For more information, call 855-4ILUMYA (855-445-8692) or visit the Ilumya website.

Ilumya uses

The Food and Drug Administration (FDA) approves prescription drugs such as Ilumya to treat certain conditions. Ilumya may also be used off-label for other conditions.

Ilumya for plaque psoriasis

Ilumya is FDA-approved to treat moderate to severe plaque psoriasis in adults who are eligible for systemic therapy or phototherapy. Systemic therapy is medication that’s taken orally or through injection and works throughout the whole body. Phototherapy (light therapy) is a treatment that involves exposing the affected skin to natural or artificial ultraviolet light.

People who are eligible for systemic therapy or phototherapy are typically those who:

  • have moderate to severe plaque psoriasis, or
  • have tried topical treatments but found that these therapies didn’t control their psoriasis symptoms

According to the National Psoriasis Foundation, plaque psoriasis is considered moderate to severe if plaques cover more than 3 percent of your body surface. For comparison, your whole hand makes up about 1 percent of your body surface.

If you have plaques on sensitive areas, such as your hands, feet, face, or genitals, your psoriasis is also considered moderate to severe.

Uses that aren’t approved

Ilumya may be used off-label for other conditions. Off-label use is when a drug that’s approved to treat one condition is prescribed to treat a different condition.

Psoriatic arthritis

Ilumya isn’t approved to treat psoriatic arthritis, but it may be prescribed off-label for this condition. Psoriatic arthritis involves psoriasis symptoms of the skin as well as sore, swollen joints.

In one small clinical study, Ilumya didn’t significantly improve psoriatic arthritis symptoms or pain when used for 16 weeks, compared to a placebo (no treatment).

However, additional studies are being done to test whether Ilumya is useful in treating psoriatic arthritis. Another long-term clinical study is currently ongoing.

Ankylosing spondylitis

Ilumya isn’t approved for the treatment of ankylosing spondylitis (arthritis that affects your spine). However, there is an ongoing clinical study to test whether it’s effective for this condition.

Ilumya dosage

The following information describes the usual dosage for Ilumya. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

Drug forms and strengths

Ilumya comes in a single-dose prefilled syringe. Each syringe contains 100 mg of tildrakizumab in 1 mL of solution.

Ilumya is given as an injection under your skin (subcutaneous).

Dosage for plaque psoriasis

The recommended dose of Ilumya for plaque psoriasis is one 100-mg subcutaneous injection.

You’ll receive the first and second injections four weeks apart. After the second dose, you’ll receive all additional doses every 12 weeks. A healthcare provider at your doctor’s office will give each injection.

What if I miss a dose?

If you forget to go to your doctor’s office for a dose, call to reschedule your appointment as soon as you remember. After that, resume the normal recommended schedule.

For instance, if you’ve already received the first two doses, you would schedule the next dose for 12 weeks after your makeup dose.

Will I need to use this drug long term?

That will depend on whether you and your doctor determine that Ilumya is safe and effective for treating your psoriasis. If you do, you may use the drug long term to control your psoriasis symptoms.

Ilumya side effects

Ilumya can cause mild or serious side effects. The following list contains some of the key side effects that may occur while taking Ilumya. This list doesn’t include all possible side effects.

For more information on the possible side effects of Ilumya or tips on how to deal with a troubling side effect, talk with your doctor or pharmacist.

More common side effects

The more common side effects of Ilumya can include:

  • upper respiratory infections
  • injection site reactions
  • diarrhea

Most of these side effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Serious side effects from Ilumya aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Serious side effects can include an allergic reaction to Ilumya. Symptoms include:

  • skin rash
  • itchiness
  • swelling of your throat, mouth, or tongue, which can cause trouble breathing
  • angioedema (swelling under your skin, typically in your eyelids, lips, hands, or feet)

Injection site reactions

In clinical studies, injection site reactions occurred in 3 percent of people who received Ilumya. Symptoms at the injection site can include:

  • redness
  • itchy skin
  • pain at the injection site
  • bruising
  • swelling
  • inflammation
  • bleeding

Injection site reactions are generally not severe and should go away within a few days. If they’re severe or don’t go away, talk with your doctor.

Diarrhea

Diarrhea occurred in 2 percent of people who received Ilumya in clinical studies. This side effect may go away with continued use of the drug. If your diarrhea is severe or lasts longer than several days, talk with your doctor.

Increased risk of infection

In clinical studies, 23 percent of people who received Ilumya got an infection. It’s important to note, though, that a similar number of infections occurred in people who received a placebo (no treatment).

The most common infections in people taking Ilumya were upper respiratory infections, such as the common cold. Up to 14 percent of people in the study had a respiratory infection. However, almost all of the infections were mild or not serious. Less than 0.3 percent of the infections were considered severe.

Ilumya increases your risk of infection because it decreases the activity of certain parts of your immune system. Your immune system is your body’s defense against infection.

Before you begin treatment with Ilumya, your doctor will check you for infections, including tuberculosis (TB). If you have a history of TB or have active TB, you’ll need to receive treatment for that condition before you start taking Ilumya.

Throughout your Ilumya treatment, it’s important to contact your doctor right away if you have symptoms of TB. These include fever, muscle aches, weight loss, cough, or blood in your mucus.

Immune reaction to Ilumya

In clinical studies, less than 7 percent of people taking Ilumya had a reaction in which their immune system developed antibodies to Ilumya.

Antibodies are proteins that fight foreign substances in your body as invaders. The body can make antibodies to any foreign substance, including monoclonal antibodies such as Ilumya.

If your body develops antibodies to Ilumya, it’s possible that the drug will no longer be effective at treating your psoriasis. It’s important to note, however, that Ilumya was made less effective in only about 3 percent of people who received it.

Alternatives to Ilumya

Other drugs are available that can treat moderate to severe plaque psoriasis. Some may be better suited for you than others. If you’re interested in finding an alternative to Ilumya, talk to your doctor to learn more about other medications that may work well for you.

Examples of other drugs that may be used to treat moderate to severe plaque psoriasis include:

  • methotrexate (Otrexup, Rasuvo, Trexall)
  • adalimumab (Humira)
  • etanercept (Enbrel)
  • secukinumab (Cosentyx)
  • ustekinumab (Stelara)
  • guselkumab (Tremfya)

Ilumya vs. Tremfya

You may wonder how Ilumya compares to other medications that are prescribed for similar uses. Here we look at how Ilumya and Tremfya are alike and different.

About

Ilumya contains tildrakizumab, which is a type of drug called a monoclonal antibody. Tildrakizumab inhibits (blocks) the activity of a protein called the interleukin-23 (IL-23) molecule. In plaque psoriasis, this molecule is involved in the skin cell buildup that leads to plaques.

Tremfya is also a monoclonal antibody that blocks the activity of IL-23. It contains the drug guselkumab.

Ilumya and Tremfya are both biologic drugs that reduce inflammation and help prevent plaque formation in people with psoriasis. Biologics are medications that are made from living organisms rather than chemicals.

Uses

Ilumya and Tremfya are both FDA-approved to treat moderate to severe plaque psoriasis in adults who are eligible for systemic therapy or phototherapy.

Systemic therapy consists of medications taken by mouth or through injections that work throughout the whole body. Phototherapy involves exposing the affected skin to natural or artificial ultraviolet light.

These types of therapies are generally used for moderate to severe plaque psoriasis or for people who don’t respond to therapies that are topical (applied to the skin).

Drug forms and administration

Ilumya comes in a single-dose prefilled syringe that contains 100 mg of tildrakizumab. Ilumya is given as an injection under the skin (subcutaneous) at the doctor’s office. The first two injections are given four weeks apart. After those injections, the doses are given every 12 weeks.

Like Ilumya, Tremfya comes in a single-dose prefilled syringe, but it contains 100 mg of guselkumab. It’s also given as a subcutaneous injection. And as with Ilumya, the first two injections are given four weeks apart. However, all doses after that are given every eight weeks.

Tremfya can be given at your doctor’s office, or self-injected at home after you receive proper training from your healthcare provider.

Side effects and risks

Ilumya and Tremfya have some similar side effects and some different. Examples are listed below.

Ilumya and Tremfya Ilumya Tremfya
More common side effects
  • upper respiratory infections
  • injection site reactions
  • diarrhea
(few unique common side effects)
Serious side effects
  • serious allergic reactions
  • potential for serious infections
(few unique serious side effects)

Effectiveness

Ilumya and Tremfya haven’t been compared in clinical studies, but both are effective for treating moderate to severe plaque psoriasis.

An indirect comparison of plaque psoriasis drugs found that Tremfya may be more effective at improving symptoms than Ilumya. In this study, people who took Tremfya were 12.4 times more likely to have a 75-percent improvement in symptoms, compared to people who took a placebo (no treatment).

In the same study, people who took Ilumya were 11 times more likely to have similar results compared to a placebo.

Costs

Ilumya and Tremfya are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

Ilumya and Tremfya generally cost about the same. The actual cost you pay for either drug will depend on your insurance plan.

Ilumya vs. other drugs

In addition to Tremfya, there are several other drugs used to treat plaque psoriasis. Below are comparisons between Ilumya and some of these medications.

Ilumya vs. Cosentyx

Ilumya contains tildrakizumab, which is a type of drug called a monoclonal antibody. Tildrakizumab inhibits (blocks) the activity of a protein called the interleukin-23 (IL-23) molecule. In plaque psoriasis, this molecule is involved in the skin cell buildup that leads to plaques.

Cosentyx is also a monoclonal antibody. It contains the drug secukinumab and blocks interleukin-17A (IL-17A). Like IL-23, IL-17A is involved in skin cell buildup that leads to plaques.

Although Ilumya and Cosentyx are both biologic drugs, they work in slightly different ways.

Biologics are medications that are made from living organisms rather than chemicals.

Uses

Ilumya and Cosentyx are both FDA-approved to treat moderate to severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy. Systemic therapy is medication that’s taken by mouth or through injection and works throughout the whole body. Phototherapy involves exposing the affected skin to ultraviolet light.

Cosentyx is also FDA-approved to treat psoriatic arthritis (psoriasis with joint arthritis) and ankylosing spondylitis (arthritis in the spine).

Drug forms and administration

Ilumya and Cosentyx are both given as injections under the skin (subcutaneous).

Ilumya is given in a doctor’s office by a healthcare provider. The first two injections are given four weeks apart. After those two injections, the doses are given every 12 weeks. Each dose is 100 mg.

The first dose of Cosentyx is typically given in a doctor’s office. After that, the drug may be self-injected at home after proper training with a healthcare provider.

For Cosentyx, two injections of 150 mg (for a total of 300 mg per dose) are given weekly for five weeks. After that, one injection is given each month. Each of these doses is typically 300 mg, although some people may only need 150 mg per dose.

Side effects and risks

Ilumya and Cosentyx have some similar side effects and some that are different. Examples of side effects for both drugs are listed below.

Ilumya and Cosentyx Ilumya Cosentyx
More common side effects
  • upper respiratory infections
  • diarrhea
  • injection site reactions
  • oral herpes (if exposed to the herpes virus)
  • itchy skin
Serious side effects
  • serious allergic reactions
  • potential for serious infections
(few unique serious side effects)
  • inflammatory bowel disease

Effectiveness

Ilumya and Cosentyx haven’t been compared in clinical studies, but both are effective for treating moderate to severe plaque psoriasis.

An indirect comparison of plaque psoriasis drugs found that Cosentyx may be more effective than Ilumya at improving symptoms. In this study, people who took 300 mg of Cosentyx were 17.5 times more likely to have a 75-percent improvement in symptoms compared to people who took a placebo (no treatment).

In the same study, people who took Ilumya were 11 times more likely to have similar results, compared to a placebo.

Costs

Ilumya and Cosentyx are both brand-name drugs. There are currently no generic forms available of either drug. Brand-name medications usually cost more than generics.

Ilumya and Cosentyx generally cost about the same. The actual cost you pay for either drug will depend on your insurance plan.

Ilumya vs. Humira

Ilumya contains tildrakizumab, which is a type of drug called a monoclonal antibody. Tildrakizumab inhibits (blocks) the activity of a protein called the interleukin-23 (IL-23) molecule. In plaque psoriasis, this molecule is involved in the skin cell buildup that leads to plaques.

Humira contains the drug adalimumab. It’s also a monoclonal antibody and blocks the activity of a protein called tumor necrosis factor-alpha (TNF-alpha). TNF-alpha is a chemical messenger that causes rapid skin cell growth in plaque psoriasis.

Although Ilumya and Humira are both biologic drugs that block immune processes, they work in different ways. Biologics are medications that are made from living organisms rather than chemicals.

Uses

Ilumya and Humira are both FDA-approved to treat moderate to severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy. Systemic therapy is medication that’s taken by mouth or through injection and works on the whole body. Phototherapy involves treating the affected skin with ultraviolet light exposure.

Humira has several other FDA-approved uses, some of which include:

Drug forms and administration

Ilumya and Humira are both given as injections under the skin (subcutaneous).

Ilumya is given in a doctor’s office by a healthcare provider. The first two injections are given four weeks apart. After those two injections, the doses are given every 12 weeks. Each dose is 100 mg.

Humira is also given in a doctor’s office, or as a self-injection at home after proper training from a healthcare provider. The first dose is 80 mg, followed by a 40-mg dose one week later. After that, a 40-mg dose is given every two weeks.

Side effects and risks

Ilumya and Humira work in different ways but have some of the same side effects. Examples of common and serious side effects for each drug are listed below.

Ilumya and Humira Ilumya Humira
More common side effects
  • upper respiratory infections
  • injection site reactions
Serious side effects
  • serious allergic reactions
  • serious infections*
(few unique serious side effects)

* Humira has boxed warnings from the FDA. A boxed warning is the strongest kind of warning the FDA requires. The warnings state that Humira increases the risk of serious infection and certain cancers.

Effectiveness

Ilumya and Humira haven’t been compared in clinical studies, but both are effective for treating moderate to severe plaque psoriasis.

One indirect comparison found that Ilumya worked about as well as Humira as a plaque psoriasis treatment. In this study, people who took either drug were about 15 times more likely to have symptom improvement than people who took a placebo (no treatment).

However, based on its analysis of other drugs, the study suggested that drugs that target IL-23, such as Ilumya, seem to be more effective at treating plaque psoriasis than TNF-blockers, such as Humira. More studies are needed.

Costs

Ilumya and Humira are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

However, there are several biosimilar forms of adalimumab (the drug in Humira) that are approved to treat psoriasis. These include Hyrimoz, Cyltezo, and Amjevita. Biosimilar drugs are similar to the biologic drug they’re based on, but they’re not exact replicas. Biosimilar drugs can cost about 30 percent less than the original drug.

Ilumya and Humira generally cost about the same. The actual cost you pay for either drug will depend on your insurance plan.

Ilumya vs. Enbrel

Ilumya contains tildrakizumab, which is a type of drug called a monoclonal antibody. Tildrakizumab inhibits (blocks) the activity of a protein called the interleukin-23 (IL-23) molecule. In plaque psoriasis, this molecule is involved in the skin cell buildup that leads to plaques.

Enbrel is also a monoclonal antibody. It contains the drug etanercept, which blocks the activity of a protein called tumor necrosis factor-alpha (TNF-alpha). TNF-alpha is a chemical messenger that causes rapid skin cell growth in plaque psoriasis.

Both Ilumya and Enbrel are biologic drugs that reduce plaque formation, but they do so in different ways. Biologics are medications that are made from living organisms rather than chemicals.

Uses

Ilumya and Enbrel are both FDA-approved to treat moderate to severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy. Systemic therapy is medication that’s taken by mouth or through injection and works on the whole body. Phototherapy involves treating the affected skin with ultraviolet light exposure.

Enbrel is also approved to treat moderate to severe plaque psoriasis in children ages 4 years and older, as well as:

  • rheumatoid arthritis
  • polyarticular juvenile idiopathic arthritis
  • psoriatic arthritis
  • ankylosing spondylitis

Drug forms and administration

Ilumya and Enbrel are both given as injections under the skin (subcutaneous).

Ilumya comes in a single-dose prefilled syringe. It’s given in the doctor’s office by your healthcare provider. The first two injections are given four weeks apart. After those two injections, the doses are given every 12 weeks. Each injection is 100 mg.

Enbrel is also given in a doctor’s office or as a self-injection at home after proper training from a healthcare provider. For the first three months, Enbrel is given twice weekly. After that, the maintenance dose is given once weekly. Each dose is 50 mg.

Enbrel is available in multiple forms, including a single-dose prefilled syringe and an autoinjector.

Side effects and risks

Ilumya and Enbrel work in different ways but have some similar side effects. Examples of common and serious side effects for each drug are listed below.

Ilumya and Enbrel Ilumya Enbrel
More common side effects
  • upper respiratory infections
  • injection site reactions
  • diarrhea
(few unique serious side effects)
  • itchy skin
Serious side effects
  • serious allergic reactions
  • potential for serious infections*
(few unique serious side effects)
  • increased risk of cancers*
  • nerve disorders, including seizures
  • blood disorders, including anemia
  • hepatitis B reactivation
  • worsening congestive heart failure

* Enbrel has boxed warnings from the FDA. A boxed warning is the strongest kind of warning the FDA requires. The warnings state that Enbrel increases the risk of serious infection and certain cancers.

Effectiveness

Ilumya and Enbrel are both effective at treating plaque psoriasis, but Ilumya may be more effective at reducing plaque symptoms.

In one clinical study, 61 percent of people who received Ilumya had symptom improvement of at least 75 percent. On the other hand, 48 percent of people who received Enbrel had similar improvements.

Costs

Ilumya and Enbrel are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

Enbrel is a little more expensive than Ilumya. The actual cost you pay for either drug will depend on your insurance plan.

Ilumya vs. methotrexate

Ilumya contains tildrakizumab, which is a type of drug called a monoclonal antibody. Tildrakizumab inhibits (blocks) the activity of a protein called the interleukin-23 (IL-23) molecule. This molecule is involved in the skin cell buildup that leads to plaques.

Methotrexate (Otrexup, Trexall, Rasuvo) is a type of drug called an antimetabolite, or a folic acid antagonist (blocker). Methotrexate works by blocking the activity of an enzyme that’s involved in skin cell growth and plaque formation.

Ilumya is a biologic drug, while methotrexate is a conventional systemic therapy. Systemic therapy refers to drugs that are taken by mouth or through injection and work throughout the whole body. Biologics are medications that are made from living organisms rather than chemicals.

Both drugs help improve psoriasis symptoms by reducing plaque formation.

Uses

Ilumya and methotrexate are both FDA-approved to treat severe plaque psoriasis. Ilumya is also approved to treat moderate plaque psoriasis. Methotrexate is meant to be used only when a person’s psoriasis symptoms are severe or disabling and don’t respond to other medications.

Methotrexate is also approved to treat certain types of cancers and rheumatoid arthritis.

Drug forms and administration

Ilumya is given as an injection under the skin (subcutaneous) at the doctor’s office by a healthcare provider. The first two injections are given four weeks apart. After those injections, the doses are given every 12 weeks. Each injection is 100 mg.

Methotrexate comes as an oral tablet, liquid solution, or an injection. For the treatment of plaque psoriasis, it’s usually taken by mouth. It can be taken as a single dose once per week, or as three doses given 12 hours apart once per week.

Side effects and risks

Ilumya and methotrexate cause different common and serious side effects. The most common and serious side effects seen in people with psoriasis are listed below. This list doesn’t include all possible side effects of either drug.

Ilumya and methotrexate Ilumya Methotrexate
More common side effects
  • upper respiratory infections
  • injection site reactions
  • nausea
  • vomiting
  • itchy skin
  • rash
  • dizziness
  • hair loss
  • skin sensitivity to sunlight
  • burning sensation on skin lesions
Serious side effects
  • serious allergic reactions*
  • serious infections*
(few unique serious side effects)
  • liver damage*
  • stomach ulcers*
  • blood disorders, including anemia and bone marrow suppression*
  • interstitial pneumonitis (inflammation in the lungs)*
  • increased risk of cancers*
  • tumor lysis syndrome in people with growing tumors*
  • severe effects to a fetus when taken during pregnancy*

* Methotrexate has several boxed warnings from the FDA describing the risk of each of the serious side effects indicated above. A boxed warning is the strongest warning the FDA requires. It alerts doctors and patients about drug effects that may be dangerous.

Effectiveness

Ilumya and methotrexate haven’t been directly compared in clinical studies, but both are effective for treating plaque psoriasis.

One indirect comparison found that Ilumya worked about as well as methotrexate for improving plaque psoriasis symptoms. However, methotrexate was more likely to cause serious side effects compared to Ilumya.

Costs

Ilumya is only available as a brand-name drug. There are currently no generic forms of Ilumya. Methotrexate is available as a generic drug as well as the brand-name drugs Trexall, Otrexup, and Rasuvo. Brand-name medications usually cost more than generics.

Ilumya costs more than the generic and brand-name forms of methotrexate. The actual cost you pay for any forms of either drug will depend on your insurance plan.

Ilumya use with other drugs

Ilumya is effective at improving plaque psoriasis on its own, but it can also be used with other medications for additional benefit. Using more than one method to treat psoriasis can help clear plaques faster and clear a greater percentage of plaques.

Combination therapy can also decrease the dosage you need of other psoriasis medications, which decreases your risk of side effects. In addition, combination therapy may reduce your risk of developing resistance to Ilumya (when the drug no longer works for you).

Examples of other therapies that can be safely used with Ilumya include:

  • topical corticosteroids, such as betamethasone
  • topical vitamin D creams and ointments (such as Dovonex and Vectical)
  • methotrexate (Trexall, Otrexup, and Rasuvo)
  • phototherapy (light therapy)

Ilumya and alcohol

There are no known interactions between alcohol and Ilumya at this time. However, diarrhea is a side effect of Ilumya for some people. Drinking alcohol can also cause diarrhea. Therefore, drinking alcohol while you receive Ilumya treatment could increase your risk of this side effect.

Alcohol can also make your Ilumya treatment less effective. This is because of alcohol’s effects on psoriasis itself, and its potential effects on how you follow your treatment plan. Alcohol use can:

  • increase inflammation that can lead to skin cell buildup
  • decrease your immune system’s ability to fight infections and skin problems
  • cause you to forget to take your medication or to stop following your treatment plan

If you take Ilumya and have trouble avoiding alcohol, talk with your doctor about ways to prevent infections and to improve your chances of successful treatment with Ilumya.

Ilumya interactions

Ilumya has few drug interactions. This is because Ilumya and other monoclonal antibodies are metabolized, or broken down, by the body in a different way than most drugs are. (Monoclonal antibodies are drugs developed in a lab from immune cells.)

Many drugs, herbs, and supplements are metabolized by enzymes in your liver. Ilumya, on the other hand, is metabolized in a similar way to naturally occurring immune cells and proteins in the body. In short, it’s broken down inside cells throughout your body. Because Ilumya isn’t broken down in your liver with other drugs, it generally doesn’t interact with them.

Ilumya and live vaccines

One important interaction for Ilumya is live vaccines. Live vaccines should be avoided during treatment with Ilumya.

Live vaccines contain small amounts of weakened viruses. Because Ilumya blocks the immune system’s normal disease-fighting response, your body may not be able to fight off the virus in a live vaccine while you take the drug.

Examples of live vaccines to avoid during Ilumya treatment include vaccines for:

Before you begin treatment with Ilumya, talk with your doctor about whether you may need any of these vaccines. You and your doctor may decide to delay treatment with Ilumya until after you’re vaccinated with any live vaccines you may need.

How to take Ilumya

Ilumya is given as an injection under the skin (subcutaneous) by a healthcare provider in a doctor’s office. It’s injected into your belly, thighs, or upper arms. Injections into your belly should be at least 2 inches away from your belly button.

Ilumya shouldn’t be injected in areas of scarring, stretch marks, or blood vessels. It should also not be administered into plaques, bruises, or red or tender areas.

Before starting Ilumya treatment

Because Ilumya weakens your immune system, your doctor will check you for tuberculosis (TB) before you start treatment. If you have active TB, you’ll receive TB treatment before starting Ilumya. And if you had TB in the past, you may need to be treated before starting Ilumya.

But even if you don’t have TB symptoms, you could have an inactive form of TB, which is called latent TB. If you have latent TB and take Ilumya, your TB could become active. If the testing shows that you have latent TB, you’ll likely need to receive TB treatment before or during your treatment with Ilumya.

Timing

The first and second Ilumya injections are given four weeks apart. After these first two doses, you’ll return to the doctor’s office every 12 weeks for another dose. If you miss an appointment or dose, make another appointment as soon as possible.

How Ilumya works

Plaque psoriasis is an autoimmune disorder, which is a condition that causes the body’s immune system to be overactive. Plaque psoriasis causes white blood cells, which help the body fight disease, to mistakenly attack the person’s own skin cells. This causes the skin cells to rapidly divide and grow.

Skin cells are produced so quickly that older cells don’t have time to fall off and make room for new cells. This overproduction and buildup of skin cells causes inflamed, scaly, painful skin patches called plaques.

Ilumya is a monoclonal antibody, which is a type of drug developed from immune cells in a lab. Monoclonal antibodies target specific parts of the immune system.

Ilumya blocks the action of an immune system protein called interleukin-23 (IL-23). With plaque psoriasis, IL-23 activates chemicals that cause the immune system to attack skin cells. By blocking IL-23, Ilumya helps to reduce the buildup of skin cells and plaques.

Because Ilumya blocks the activity of IL-23, it’s referred to as an interleukin inhibitor.

How long does it take to work?

Ilumya will start to work as soon as you start taking it. However, it takes time to build up in your system and take full effect, so it may be several weeks before you see any results.

In clinical studies, after one week of treatment, fewer than 20 percent of people taking Ilumya saw an improvement in plaques. However, after 12 weeks, more than half of people who received Ilumya saw a significant improvement in their psoriasis symptoms. The number of people with improved symptoms continued to increase through 28 weeks of treatment.

Ilumya and pregnancy

It isn’t known if Ilumya is safe to use during pregnancy. Animal studies have shown some risk to the fetus when Ilumya is given to a pregnant female. However, animal studies don’t always predict what will happen with humans.

If you’re pregnant or planning to become pregnant, talk with your doctor about the benefits and risks of Ilumya treatment during pregnancy.

Ilumya and breastfeeding

It’s not known if Ilumya passes into human breast milk. In animal studies, Ilumya passed into breast milk, exposing the breastfeeding young to the drug. However, animal studies don’t always predict what will happen in humans.

If you’re considering Ilumya treatment while breastfeeding, talk with your doctor about the benefits and risks.

Common questions about Ilumya

Here are answers to some frequently asked questions about Ilumya.

Does Ilumya cure plaque psoriasis?

No, Ilumya does not cure plaque psoriasis. There is currently no cure for this disease. However, treatment with Ilumya can help improve your psoriasis symptoms.

I have always used creams for my plaque psoriasis. Why do I need to start receiving injections?

Your doctor may have decided that a systemic treatment could do more to relieve your symptoms than your creams. Systemic drugs are given by injection or taken by mouth and work throughout the whole body.

Systemic treatments such as Ilumya are generally more effective at improving psoriasis symptoms than topical treatments (drugs applied to the skin). This is because they work from the inside out. They target the immune system itself, which causes your psoriasis plaques. This can help both clear and prevent psoriasis plaques.

Topical treatments, on the other hand, generally treat the plaques after they’re formed.

Systemic treatments are sometimes used in combination with, or instead of, topical treatments. They may be used if:

  • topical medications don’t improve your plaque psoriasis symptoms enough, or
  • plaques cover a large portion of your skin (typically 3 percent or more), making topical treatments impractical. This is considered moderate to severe psoriasis.

How long will I need to take Ilumya?

You may take Ilumya on a long-term basis if you and your doctor decide that Ilumya is safe and effective for you.

What’s a biologic drug?

A biologic drug is a medication that’s created from human or animal proteins. Biologic drugs used to treat autoimmune diseases, such as plaque psoriasis, work by interacting with the body’s immune system. They do this in targeted ways to reduce inflammation and other symptoms of an overactive immune system.

Because they interact with very specific immune system cells and proteins, biologics are thought to have fewer side effects compared to drugs that affect a wider range of body systems, as many drugs do.

When used to treat psoriasis, biologic drugs are generally used for people with moderate to severe plaque psoriasis who don’t respond to other treatments (such as topical therapy).

Is Ilumya used to treat psoriatic arthritis?

Ilumya is not FDA-approved to treat psoriatic arthritis, but it may be used off-label for that purpose.

In one small clinical study, Ilumya didn’t significantly improve psoriatic arthritis symptoms or pain, but additional studies are being done to test whether it’s useful for this condition. Another long-term clinical study is currently ongoing.

Why do I need a TB test before starting treatment with Ilumya?

Your doctor will test you for active or latent tuberculosis (TB) before you start treatment with Ilumya. People with latent TB may not know they have the infection because there are often no symptoms. A blood test is the only way to know if someone with latent TB is infected.

Testing for TB before treatment with Ilumya is important because Ilumya weakens the immune system. When the immune system is weakened, it can’t fight off infections, and latent TB can become active. Symptoms of active TB include fever, fatigue, weight loss, coughing up blood, and chest pain.

If you test positive for TB, you’ll likely need to receive TB treatment before starting Ilumya.

What can I do to prevent infections while I take Ilumya?

Ilumya treatment weakens your immune system and increases your risk of infections. Examples of such infections include tuberculosis, shingles, fungal infections, and respiratory infections.

However, there are several things you can do to help prevent infections:

  • Stay up-to-date on vaccinations, including for influenza (the flu).
  • Avoid smoking.
  • Wash your hands with soap often.
  • Follow a healthy diet.
  • Get enough sleep.
  • Avoid being around people who are ill, if possible.

Ilumya warnings

Before taking Ilumya, talk with your doctor about your health history. Ilumya may not be right for you if you have certain medical conditions. These include:

  • History of a serious hypersensitivity reaction to Ilumya or any of its ingredients. If you have had a severe reaction to Ilumya in the past, you shouldn’t receive treatment with this drug. Severe reactions include swelling of the face or tongue and trouble breathing.
  • Active infections or history of repeated infections. Ilumya shouldn’t be started by people with a current infection or a history of repeated infections. If you develop an infection while taking Ilumya, tell your doctor right away. They will monitor you closely and may decide to stop your Ilumya treatment until the infection is cured.
  • Tuberculosis. If you have latent TB or active TB, you may need TB treatment before starting Ilumya. You shouldn’t start Ilumya if you have active TB. (If you have latent TB, your doctor may have you start taking Ilumya during your TB treatment.)

Professional information for Ilumya

The following information is provided for clinicians and other healthcare professionals.

Mechanism of action

Ilumya contains the humanized monoclonal antibody tildrakizumab. It binds to the p19 subunit of the interleukin-23 (IL-23) cytokine and prevents it from binding to the IL-23 receptor. Blocking IL-23 activity prevents activation of the proinflammatory T-helper cell 17 (Th17) pathway.

Pharmacokinetics and metabolism

Absolute bioavailability is up to 80 percent following subcutaneous injection. Peak concentration is reached in six days. Steady-state concentration is reached by week 16.

Ilumya is degraded to small peptides and amino acids via catabolism. Elimination half-life is approximately 23 days.

Contraindications

Ilumya is contraindicated in patients with a history of serious hypersensitivity reaction to the drug or any of its excipients.

Vaccines

Avoid live vaccines in patients receiving Ilumya.

Pretreatment

All patients should be evaluated for latent or active tuberculosis prior to treatment with Ilumya. Do not administer Ilumya to patients with active TB. Patients with latent TB should start TB treatment before initiating treatment with Ilumya.

Storage

Ilumya should be stored in the refrigerator at 36⁰F to 46⁰F (2⁰C to 8⁰C). Store in the original container to protect from light. Ilumya can be kept at room temperature — up to 77⁰F (25⁰C) — for up to 30 days. Once stored at room temperature, do not place back in the refrigerator. Do not freeze or shake. Let Ilumya sit at room temperature for 30 minutes prior to administration.

Disclaimer: MedicalNewsToday has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.