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Skyrizi vs Ilumya
Introduction
For patients with moderate to severe plaque psoriasis, certain drugs that target specific proteins in the immune system can help in managing symptoms and reducing skin inflammation. Skyrizi and Ilumya are two such medications prescribed for this condition. Both act by targeting different aspects of the immune response but have similar effects in patients with plaque psoriasis.
Skyrizi is an interleukin-23 (IL-23) inhibitor, a type of biologic medication that targets a specific protein involved in the inflammatory process. On the other hand, Ilumya specifically inhibits the activity of interleukin-17A (IL-17A), another protein which plays a significant role in triggering inflammation.
Both these medications work to reduce skin inflammation and slow down rapid cell growth associated with psoriasis; however, they vary based on dosing schedule and side effect profile. It's important to discuss these factors thoroughly with your healthcare provider before deciding on treatment options.
What is Skyrizi?
Risankizumab-rzaa (the generic name for Skyrizi) belongs to the class of drugs known as interleukin inhibitors, which marked a significant advancement in psoriasis treatment. Risankizumab-rzaa was first approved by the FDA in 2019. Skyrizi works by blocking the action of a specific protein that causes inflammation and excessive skin cell production - common issues with psoriasis. It is prescribed for moderate-to-severe plaque psoriasis.
Tildrakizumab-asmn (the generic name for Ilumya), another member of the same drug class, was also approved by the FDA recently, in 2018. Both medicines work similarly but have varying intervals between doses. For instance, Skyrizi is administered every twelve weeks after two initial doses at weeks zero and four while Ilumya is given once every twelve weeks following two starter doses at weeks zero and four.
From an adverse effects perspective, both these medications are well-tolerated; however, they may potentially lead to serious infections due to their immunosuppressive nature.
What conditions is Skyrizi approved to treat?
Skyrizi and Ilumya are approved for the treatment of moderate to severe plaque psoriasis:
- Skyrizi is used in adults who may benefit from taking injections or pills (systemic therapy) or phototherapy (treatment using ultraviolet or UV light).
- Ilumya, on the other hand, is used for adults with plaque psoriasis who are candidates for systemic therapy or phototherapy.
How does Skyrizi help with these illnesses?
Skyrizi works to manage psoriasis by blocking the actions of interleukin-23, a protein in the body that is involved in inflammation and immune responses. It does this by binding directly to this protein, preventing it from interacting with its receptor on the surface of cells and thus interrupting the inflammatory signal pathway. Interleukins are cytokines - chemicals that act as messengers between cells - playing crucial roles in triggering immune responses such as inflammation, which can lead to symptoms like redness, swelling, and scaling skin associated with psoriasis. It's believed individuals with psoriasis have an overactive response involving interleukin-23. Therefore, by inhibiting interleukin-23 activity, Skyrizi can limit the effects of inflammation seen in psoriasis patients and help them better manage their condition.
What is Ilumya?
Ilumya, known generically as tildrakizumab, is an interleukin-23 (IL-23) inhibitor. It works by selectively binding to the p19 subunit of IL-23 and inhibiting its interaction with the cell-surface IL-23 receptor. Ilumya was approved by the FDA in 2018 for treatment of adults with moderate-to-severe plaque psoriasis who are candidates for systemic therapy or phototherapy. Like Skyrizi, it does not inhibit tumor necrosis factor alpha (TNFα), but due to its specific action on IL-23, it has a different side effect profile compared to TNFα inhibitors. In particular, Ilumya can lower your ability to fight infections and may increase your risk of infections. Some people have serious infections while taking Ilumya which may require hospitalization; therefore patient screening for tuberculosis is recommended before starting treatment with this drug class.
What conditions is Ilumya approved to treat?
Ilumya is an FDA-approved medication for the treatment of the following conditions:
- Moderate to severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy
- Active psoriatic arthritis, with its recent approval expanding its use beyond just psoriasis.
How does Ilumya help with these illnesses?
Interleukin-23 is a cytokine that plays a key role in many processes in the body, particularly those related to inflammatory responses. In conditions such as psoriasis, higher than normal levels of interleukin-23 can lead to excessive inflammation and skin cell production — hallmarks of the condition. Ilumya works by blocking the action of interleukin-23, thereby reducing symptoms associated with psoriasis. Its effect on other immune system components may also play roles in its efficacy as a treatment for moderate-to-severe plaque psoriasis. Because it specifically targets interleukin-23 and not other cytokines like Skyrizi does (which inhibits both IL-23 and IL-12), it may be prescribed when a patient does not respond well to other treatments or prefers an injection only once every three months compared to Skyrizi's every 12 weeks schedule.
How effective are both Skyrizi and Ilumya?
Both risankizumab (Skyrizi) and tildrakizumab (Ilumya) are FDA approved biologic medications used in the treatment of moderate to severe plaque psoriasis. They both work by targeting a specific protein involved in inflammation, interleukin-23 (IL-23), thus reducing symptoms of this autoimmune disease.
The effectiveness of Skyrizi and Ilumya was directly compared in several clinical trials; they exhibited similar efficacy rates at managing symptoms of psoriasis, as well as comparable safety profiles. In these studies, no significant differences were noted between patients receiving Skyrizi or Ilumya when assessing factors such as clearance rate, reduction of symptom severity or maintenance duration.
A review published in 2019 highlighted that Skyrizi demonstrated high efficacy from the earliest weeks following initiation up until one year later with consistent safety profile throughout the period. It has also been reported that it is well-tolerated among different age groups and those with concurrent health conditions associated with psoriasis like arthritis or cardiovascular diseases.
Analysis conducted in 2020 revealed Ilumya to be more effective than placebo at treating psoriasis, showing similar efficacy compared to other IL-23 inhibitors such as guselkumab but not quite matching up to the success rate seen with risankizumab specifically for complete skin clearance. Despite this slight disadvantage on full skin clearance parameter , it's important to note that its longer dosing interval might make it appealing option for many patients who prefer less frequent injections .
Sources:
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6796998/
- https://www.pso-protection.com/skyrizi
- https://jamanetwork.com/journals/jama/fullarticle/2776736 4 )https://www.medicalnewstoday.com/articles/ilumya-vs-skyrizi-for-psoriasis#il-23-inhibitors
At what dose is Skyrizi typically prescribed?
Injectable dosages of Skyrizi are typically 150 mg every twelve weeks, following two initial doses at week zero and week four. Studies have shown that this dosage is effective in treating moderate to severe plaque psoriasis in most adults. On the other hand, Ilumya is administered as a subcutaneous injection of 100 mg every twelve weeks after two initial doses at weeks zero and four. The response to these medications should be evaluated periodically, and treatment may need adjustment based on individual patient's condition. In each case, exceeding the recommended dose can lead to increased risk of side effects without added therapeutic benefits.
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At what dose is Ilumya typically prescribed?
Ilumya therapy for the treatment of moderate-to-severe plaque psoriasis in adults begins with an initial dosage of 100 mg given by subcutaneous injection at weeks 0, and 4. Subsequent dosages are then administered every twelve weeks (84 days). The Ilumya dose is consistent and does not need to be increased over time. It's important to monitor your response to the medication, as it may take a few months before significant improvements are noticed. Your healthcare provider will evaluate progress during this period and adjust treatment if necessary.
What are the most common side effects for Skyrizi?
Common side effects of Skyrizi and Ilumya include:
- Upper respiratory infections
- Injection site reactions (redness, itching, pain)
- Headache
- Fatigue
- Diarrhea
- Nausea
- Musculoskeletal pain (pain in the muscles or bones)
It's worth noting that these medications can potentially increase the risk of infection. If you experience any severe symptoms such as fever, persistent coughing, or signs of an infection while taking either medication, seek medical attention immediately.
Are there any potential serious side effects for Skyrizi?
Skyrizi and Ilumya are both used to treat moderate-to-severe plaque psoriasis in adults. However, they can have different side effects.
In the case of Skyrizi, there may be potential severe side effects such as:
- Signs of a serious infection: fever, sweats or chills; muscle aches; cough; shortness of breath; blood in your phlegm, weight loss
- Signs of an allergic reaction: hives; difficulty breathing or swallowing; swelling of your face, lips, tongue or throat
- Symptoms related to tuberculosis (TB): persistent coughing that doesn't improve over time and contains blood occasionally.
On the other hand with Ilumya:
- You could experience symptoms indicating a possible serious infection such as flu-like symptoms accompanied by fever and chills.
- Severe allergies might also manifest through skin reactions like rashes or hives.
- Similar to Skyrizi you should monitor for signs pointing towards TB.
If you encounter any mentioned above while taking either drug it's crucial to reach out to your doctor immediately.
What are the most common side effects for Ilumya?
Potential side effects of Ilumya:
- Mild redness or rash at the injection site
- Upper respiratory tract infections, such as stuffy nose and sore throat
- Diarrhea
- Headache and dizziness
- Muscle or joint pain
- Fatigue While these symptoms are usually mild and manageable, serious allergic reactions can occasionally occur. It's vital to be aware of any changes in your health after starting Ilumya treatment, including signs of tuberculosis infection such as coughing up blood, ongoing fatigue or weight loss. As with all medications, it is essential to discuss potential risks and benefits with a healthcare provider.
Are there any potential serious side effects for Ilumya?
While Ilumya is generally well-tolerated, it's crucial to be aware of the rare but serious side effects that may occur. These include:
- Signs of an allergic reaction such as hives, itching, or skin rash
- Swelling in your face or throat and difficulty breathing
- Fever with stomach pain and weight loss
- Diarrhea or bloody stools
- Unusual tiredness or feeling light-headed
- Muscle weakness and aching joints
If you experience any of these symptoms while taking Ilumya for your psoriasis condition, seek immediate medical attention. You should always keep all appointments with your doctor while on this medication so they can monitor you for possible side effects.
Contraindications for Skyrizi and Ilumya?
Just like other medications used to treat psoriasis, both Skyrizi and Ilumya may cause your immune system to weaken, making you more susceptible to infections. If you notice any signs of infection such as fever, chills or persistent sore throat while on these drugs, seek immediate medical attention.
Neither Skyrizi nor Ilumya should be administered if you have a current serious infection or are taking immunosuppressive drugs. Always inform your healthcare provider about the medications and supplements you are currently taking; these can interact with Skyrizi or Ilumya in potentially harmful ways.
Both drugs require regular monitoring by your doctor as they may increase the risk of certain types of cancer due to their effect on the immune system. It is also essential for patients using these treatments to avoid receiving live vaccines during treatment period because it could lead to an active disease.
How much do Skyrizi and Ilumya cost?
For the brand name versions of these drugs:
- The price of two injections of Skyrizi (75 mg/0.83 mL) averages around $22,000, which works out to approximately $367/day, considering a dosing schedule every 12 weeks.
- The price for one syringe of Ilumya (100 mg/mL) is about $20,500, working out to approximately $240/day given that it's typically administered every 12 weeks.
Thus, if you're following the standard dosage recommendations for either medication, then brand-name Ilumya tends to be less expensive on a per-day treatment basis. Please note that cost should not be a primary consideration in determining which of these drugs is right for you as both medications are used for moderate-to-severe plaque psoriasis and their effectiveness may vary among individuals.
As with most biologic medications used in the treatment of autoimmune conditions like psoriasis or psoriatic arthritis - such as adalimumab (Humira), ixekizumab (Taltz), secukinumab (Cosentyx) – there are currently no generic alternatives available for either Skyrizi or Ilumya due to patent protections and complexities in biological drug development process.
Popularity of Skyrizi and Ilumya
Risankizumab, under the brand name Skyrizi, and tildrakizumab, known as Ilumya, are both prescribed for the treatment of moderate to severe plaque psoriasis.
In 2020, it was estimated that about 300 thousand people in the US were prescribed Skyrizi. This accounted for almost 6% of prescriptions given out for this class of dermatological treatments. Since its introduction in 2019 by AbbVie and Boehringer Ingelheim Pharmaceuticals Inc., Skyrizi has been steadily gaining popularity among patients suffering from plaque psoriasis.
Ilumya on the other hand was introduced a year earlier than Skyrizi in March 2018 by Sun Pharma Global FZE. It's used less frequently with an estimated number of prescriptions reaching approximately 100 thousand in America during 2020 which accounts for nearly 2% of all comparable dermatologic drugs dispensed that year.
Conclusion
Both Skyrizi (risankizumab) and Ilumya (tildrakizumab) have been shown to be effective treatments for moderate-to-severe plaque psoriasis in numerous clinical studies. They work by targeting the interleukin-23, a protein that is involved in inflammatory processes. The drugs might be used together or separately depending on the patient's condition and physician's assessment.
Skyrizi has demonstrated higher efficacy rates compared to Ilumya in some trials but requires more frequent administration - every 12 weeks after initial doses at week 0 and 4. On the other hand, Ilumya is administered less frequently - every 12 weeks starting from second dose which is given four weeks after the first one.
Both medications are not available as generics so they can be quite expensive especially for patients paying out of pocket. Both Skyrizi and Ilumya may require an adjustment period before their full effects become noticeable.
The side effect profiles of both drugs are somewhat similar, with upper respiratory infections being commonly reported for both, although some differences exist such as fungal skin infections being more common with Skyrizi while injection site reactions occur more frequently with Ilumya. As always, patients should monitor their health closely when starting new treatment regimens and seek immediate medical help if serious side effects arise.