Tildrakizumab SC Injection for Psoriatic Arthritis

Enrolling by invitation at 119 trial locations

Overseen By Head, Clinical Developement

Age: 18+

Sex: Any

Trial Phase: Phase 3

Sponsor: Sun Pharma Global FZE

Disqualifiers: Pregnancy, Breastfeeding, Others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Pivotal Trial (Near Approval) This treatment is in the last trial phase before FDA approval

Prior Safety Data This treatment has passed at least one previous human trial

Approved in 2 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a treatment called Tildrakizumab (an SC injection) for individuals with psoriatic arthritis, a condition causing joint pain and skin issues. Researchers aim to determine if this medication, administered every 12 weeks, reduces symptoms more effectively than current options. The trial is open to those who have successfully completed a related study. Ideal candidates have psoriatic arthritis and did not encounter reasons to stop treatment in the previous study. As a Phase 3 trial, this study represents the final step before FDA approval, offering participants an opportunity to contribute to the development of a potentially groundbreaking treatment.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

Is there any evidence suggesting that Tildrakizumab is likely to be safe for humans?

Research has shown that tildrakizumab is generally safe for people with psoriatic arthritis. In various studies, patients using tildrakizumab experienced noticeable improvements in joint and skin symptoms. These studies also found that the treatment rarely caused serious side effects. While some patients experienced mild reactions, the treatment was overall considered safe. Additionally, the FDA has already approved tildrakizumab for treating plaque psoriasis, indicating it has passed strict safety tests for that condition. ^{1 2 3 4 5}

Why do researchers think this study treatment might be promising for psoriatic arthritis?

Tildrakizumab stands out among treatments for psoriatic arthritis because it specifically targets the interleukin-23 (IL-23) pathway, which plays a crucial role in inflammatory processes. While many current treatments, like TNF inhibitors, focus on blocking tumor necrosis factor, Tildrakizumab's unique mechanism offers a different approach that could be more effective for some patients. Additionally, it is administered via a subcutaneous injection every 12 weeks, providing a convenient and less frequent dosing schedule compared to some other biologics that require more frequent administration. Researchers are excited about Tildrakizumab because it has the potential to offer improved efficacy and convenience for patients with psoriatic arthritis.

What evidence suggests that Tildrakizumab might be an effective treatment for psoriatic arthritis?

Research has shown that tildrakizumab, the treatment under study in this trial, effectively treats psoriatic arthritis. Studies have found that patients using tildrakizumab experienced significant improvements, with more people seeing a 20% reduction in joint symptoms. Additionally, tildrakizumab has effectively reduced psoriasis symptoms over several years. It improves both joint and skin issues, making it a promising choice for those with psoriatic arthritis. ^{2 4 6 7 8}

Are You a Good Fit for This Trial?

This trial is for patients with Psoriatic Arthritis who completed a previous study without early discontinuation. Participants must understand the study requirements, agree to follow them, and provide written consent. Women of childbearing potential must abstain from sex or use dual contraception; pregnant or breastfeeding women are excluded.

Inclusion Criteria

You have PsA and you met all the requirements for the main study, completed the treatment, and did not have to stop early for any reasons.

You must agree to comply with the study restrictions, scheduled treatments, laboratory assessments, and other study procedures

I understand what participating in this study involves.

Exclusion Criteria

I agree to either not have heterosexual sex or use two forms of birth control.

Any condition that in the opinion of the Investigator represents an obstacle for study conduct and/or represents a potential unacceptable risk for the subject.

Subject has previously been enrolled in this long-term extension study.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Open-label extension

Participants continue receiving Tildrakizumab to evaluate long-term safety and efficacy

124 weeks

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Tildrakizumab

Trial Overview The trial is testing Tildrakizumab injections in an open-label phase 3 setting to evaluate its long-term safety and effectiveness in treating Psoriatic Arthritis. Patients will receive subcutaneous injections as part of their treatment regimen.

How Is the Trial Designed?

Group I: TILD q12 weeks Experimental Treatment 1 Intervention

Tildrakizumab is already approved in European Union, United States for the following indications:

Approved in European Union as Ilumya for:

• Moderate to severe plaque psoriasis

Approved in United States as Ilumya for:

• Moderate to severe plaque psoriasis

Who Is Running the Clinical Trial?

Sun Pharma Global FZE

Lead Sponsor

Trials

34

Recruited

10,200+

Sun Pharmaceutical Industries Limited

Lead Sponsor

Trials

71

Recruited

14,000+

Dilip Shanghvi

Sun Pharmaceutical Industries Limited

Chief Executive Officer since 1993

Majored in Cellular and Molecular Biology at the University of Michigan – Ann Arbor

Dr. Azadar H. Khan

Sun Pharmaceutical Industries Limited

Chief Medical Officer since 2023

MD from a recognized institution

Published Research Related to This Trial

In a study involving 101 patients with ankylosing spondylitis, tildrakizumab did not show a significant improvement in the ASAS20 response rate compared to placebo at week 24, with a response rate of 74.0% for tildrakizumab versus 80.4% for placebo.

The treatment was generally well tolerated, with no unexpected safety issues reported, but the study was terminated early due to the lack of efficacy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Randomized, Double-Blind, Placebo-Controlled Phase 2a Study of Tildrakizumab Efficacy and Safety in Patients With Active Ankylosing Spondylitis. Peters, E., Chou, RC., Rozzo, SJ., et al.[2023]

Tildrakizumab is a monoclonal antibody that specifically targets interleukin-23 p19, which plays a key role in the inflammatory process of chronic plaque psoriasis.

The drug received FDA approval based on positive outcomes from the phase III reSURFACE clinical trial program, demonstrating its efficacy for adults with moderate-to-severe chronic plaque psoriasis who require systemic therapy or phototherapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Tildrakizumab: First Global Approval. Markham, A.[2020]

In a 52-week study involving 237 adults with moderate-to-severe plaque psoriasis, tildrakizumab demonstrated high efficacy, with 90.91% of patients achieving at least a 75% reduction in psoriasis severity (PASI 75) and 58.68% achieving complete skin clearance (PASI 100) by Week 52.

The safety profile of tildrakizumab was favorable, with no significant adverse events reported, and no patients had to discontinue treatment due to side effects, indicating it is a well-tolerated option for psoriasis management in real-life settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Real-life effectiveness of tildrakizumab in chronic plaque psoriasis: A 52-week multicentre retrospective study-IL PSO (Italian landscape psoriasis). Narcisi, A., Valenti, M., Gargiulo, L., et al.[2023]

In two phase 3 trials involving 1862 patients, tildrakizumab (200 mg and 100 mg) demonstrated significant efficacy in treating moderate-to-severe chronic plaque psoriasis, achieving PASI 75 responses in 62-66% of patients compared to only 6% in the placebo group.

Tildrakizumab was well tolerated, with serious adverse events being low and similar across all treatment groups, indicating a favorable safety profile for this new treatment option.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Tildrakizumab versus placebo or etanercept for chronic plaque psoriasis (reSURFACE 1 and reSURFACE 2): results from two randomised controlled, phase 3 trials. Reich, K., Papp, KA., Blauvelt, A., et al.[2019]

In a study of 51 patients with moderate-to-severe plaque psoriasis who had previously failed biologic treatments, tildrakizumab showed significant effectiveness, with a marked reduction in the Psoriasis Area Severity Index (PASI) score from 19.2 at baseline to 0.6 at 48 weeks (P < 0.001).

The treatment also led to substantial improvements in Body Surface Area (BSA) and Dermatology Life Quality Index (DLQI) scores, indicating enhanced quality of life for patients, with significant results observed at both 12 and 48 weeks.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness and Safety After a Switch to Tildrakizumab: A Real World Multicenter Italian Study in Psoriasis. Di Brizzi, EV., Buononato, D., Benvenuto, P., et al.[2023]

Tildrakizumab, an antibody targeting IL-23, was found to be safe and well tolerated in healthy adults, with mild adverse events like upper respiratory infections and headaches reported.

The pharmacokinetics showed that both intravenous and subcutaneous doses resulted in slow clearance and a long half-life, with subcutaneous bioavailability around 80%, indicating effective delivery of the drug.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Pharmacokinetics of Tildrakizumab (MK-3222), an Anti-IL-23 Monoclonal Antibody, After Intravenous or Subcutaneous Administration in Healthy Subjects. Khalilieh, S., Hodsman, P., Xu, C., et al.[2019]

In a phase IIb trial involving 355 adults with moderate-to-severe chronic plaque psoriasis, tildrakizumab demonstrated significant efficacy, with PASI 75 responses of up to 74.4% at week 16 compared to only 4.4% in the placebo group, indicating its effectiveness in reducing psoriasis severity.

Tildrakizumab was generally safe and well tolerated, with serious adverse events reported but not common, suggesting that targeting IL-23p19 could be a promising approach for psoriasis treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Tildrakizumab (MK-3222), an anti-interleukin-23p19 monoclonal antibody, improves psoriasis in a phase IIb randomized placebo-controlled trial. Papp, K., Thaçi, D., Reich, K., et al.[2018]

In the TRIBUTE study involving 177 adult patients with moderate-to-severe plaque psoriasis, treatment with Tildrakizumab (TIL) 100 mg for 24 weeks resulted in significant improvements in psoriasis severity, with 88.4% of patients achieving a PASI score of ≤3 and 92.5% achieving PASI 75.

The treatment also led to notable enhancements in health-related quality of life, including reduced pruritus, pain, and improved sleep, with a high patient satisfaction score (mean TSQM score of 80.5), and a favorable safety profile with only one serious adverse event reported.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Tildrakizumab improves high burden skin symptoms, impaired sleep and quality of life of moderate-to-severe plaque psoriasis patients in conditions close to clinical practice. Costanzo, A., Llamas-Velasco, M., Fabbrocini, G., et al.[2023]

Citations

1. rheumatologyadvisor.com rheumatologyadvisor.com/news/tildrakizumab-meets-acr20-endpoint-in-two-psoriatic-arthritis-trials/

Tildrakizumab Meets ACR20 Endpoint in Two Psoriatic ... Findings showed that both studies met the primary endpoint, with a higher proportion of tildrakizumab-treated patients achieving ACR20 responses ...

2. ilumyapro.com ilumyapro.com/ilumya-results

Pivotal Trial Data | ILUMYA® (tildrakizumab-asmn) View ILUMYA® (tildrakizumab-asmn) pivotal trial data and how it provided consistent reduction of detectable psoriasis activity through 5 years.

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11979299/

Real-World Effectiveness of Tildrakizumab for Moderate-to- ... Conclusions: Tildrakizumab is effective for the treatment of moderate-to-severe plaque psoriasis in adults in a real-world setting in Canada.

4. ard.bmj.com ard.bmj.com/content/80/9/1147

Efficacy and safety of tildrakizumab in patients with active ... Conclusions Tildrakizumab treatment significantly improved joint and skin manifestations of PsA other than dactylitis and enthesitis. Treatment was generally ...

5. clinicaltrials.gov clinicaltrials.gov/study/NCT04314531

NCT04314531 | Efficacy and Safety of Tildrakizumab ... This is a randomized, double-blinded, placebo-controlled, Phase 3 study to evaluate the efficacy and safety of tildrakizumab compared to placebo in anti-TNF ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8372392/

Efficacy and safety of tildrakizumab in patients with active ... Tildrakizumab treatment significantly improved joint and skin manifestations of PsA other than dactylitis and enthesitis. Treatment was generally well ...

7. clinicaltrials.gov clinicaltrials.gov/study/NCT04314531

NCT04314531 | Efficacy and Safety of Tildrakizumab ... This is a randomized, double-blinded, placebo-controlled, Phase 3 study to evaluate the efficacy and safety of tildrakizumab compared to placebo in anti-TNF ...

8. clinicaltrials.gov clinicaltrials.gov/study/NCT04314544

NCT04314544 | Efficacy and Safety of Tildrakizumab ... This is a multicenter Phase III, Randomized, Double-Blind, Single-Dose, Placebo-Controlled Study to Demonstrate the Efficacy and Safety of tildrakizumab in ...