An anti-IL-23 antibody injection for psoriasis
Tildrakizumab
A regular injection used to treat moderate to severe plaque psoriasis by calming part of the immune system that drives the condition.
What is Tildrakizumab?
Tildrakizumab is a specialist biologic medicine used to treat moderate to severe plaque psoriasis when other treatments have not worked well enough or are unsuitable. It is an antibody given as an injection under the skin that blocks a signalling protein called interleukin-23 (IL-23), which drives the skin inflammation of psoriasis, helping to clear the plaques. Because it calms part of the immune system, it can raise the risk of infections, so people are screened for tuberculosis before starting and watched for signs of infection. Live vaccines are generally avoided while using it. It is given on a regular schedule by a specialist service.
Education and reference only. This is a plain-language guide to Tildrakizumab — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Tildrakizumab is a biologic medicine, a type of antibody, used to treat moderate to severe plaque psoriasis, a long-term skin condition that causes raised, scaly patches. It is used when creams, light treatment or other medicines have not controlled the condition well enough or are not suitable. It works by calming a specific part of the immune system that drives psoriasis, helping the skin to clear over time. It is given as an injection under the skin on a regular schedule, often at home after training, and is prescribed and supervised by a specialist dermatology service.
How it works
Psoriasis is driven by an overactive immune response in the skin, with a signalling protein called interleukin-23 (IL-23) playing a central role in keeping that inflammation going. Tildrakizumab is an antibody that blocks IL-23, turning down this part of the immune response so that the skin inflammation settles and plaques gradually clear. Because it works steadily over weeks, it is given as a course of injections on a regular schedule rather than as an immediate treatment. By targeting one specific signal, it aims to calm psoriasis while affecting the rest of the immune system as little as possible, though some increased infection risk remains.
Company & origin
Originated / developed by: Specialist manufacturer.
A specialist biologic injection used in the UK to treat moderate to severe plaque psoriasis that has not responded well to other treatments.
Practical use
How to take Tildrakizumab
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Use it on the regular schedule your specialist team sets, injecting it under the skin as you have been trained.
- Make sure you have been screened for tuberculosis before starting, as the team will arrange.
- Report any signs of infection, such as fever, a persistent cough or feeling unwell, promptly.
- Check with your team before having any vaccinations, as live vaccines are generally avoided while on it.
- Give it time to work, as the skin usually improves over weeks rather than straight away.
Weighing it up
Advantages & disadvantages of Tildrakizumab
Advantages
- Can clear or greatly improve moderate to severe plaque psoriasis when other treatments have not worked.
- Given as an injection only every so often, on a regular schedule, often at home after training.
- Targets one specific immune signal, aiming to calm psoriasis with limited effect on the rest of the immune system.
Disadvantages
- Calms part of the immune system, so it can raise the risk of infections.
- Needs tuberculosis screening before starting and watching for infections during treatment.
- Works gradually and needs specialist supervision and regular injections.
Practical use
Good to know
The main thing to understand is that tildrakizumab calms part of the immune system, which is how it clears psoriasis but also why it can make infections more likely. Because of this, you are usually screened for tuberculosis (TB) before starting, as the medicine can allow a hidden TB infection to flare, and you should report any signs of infection such as fever, a persistent cough or feeling generally unwell. It works gradually, so the skin improves over weeks rather than days, and it is given as injections on a regular schedule that the specialist sets. Live vaccines are generally avoided while on it, so check before any vaccination. The most common side effects are mild infections such as colds and reactions where the injection is given. The specialist team reviews how well it is working and watches for infections over time.
Who should not take it / use with caution
- People who have had a serious allergic reaction to tildrakizumab should not use it.
- It is not started in people with an active serious infection until that infection is treated.
- It is used with care in people with tuberculosis or a history of it, which is screened for first, and live vaccines are generally avoided.
Monitoring
- Screening for tuberculosis before treatment and watching for signs of infection during it.
- Reviewing how well the skin is responding over time.
- Watching for allergic-type or injection-site reactions.
Side effects
- Mild infections such as colds or sore throats.
- Redness, soreness or swelling where the injection is given.
- Less commonly, more serious infections or allergic-type reactions, which should be reported.
Key interactions
- Live vaccines are generally avoided while using it, so check before any vaccination.
- Care is needed if it is combined with other medicines that suppress the immune system.
- There are few well-established routine medicine interactions, but tell your team about everything you take.
Available as: A solution for injection under the skin, often given by the patient or a carer.
Answers
Tildrakizumab: frequently asked questions
What is tildrakizumab used for?
It is used to treat moderate to severe plaque psoriasis when other treatments have not worked well enough, by blocking an immune signal (IL-23) that drives the skin inflammation.
Why do I need a tuberculosis test before starting?
Because it calms part of the immune system, it can allow a hidden tuberculosis infection to flare, so you are screened for TB before treatment begins.
How quickly does it work?
It works gradually, so the skin usually improves over weeks rather than days; your specialist will review how well it is helping.
Can I have vaccinations while using it?
Live vaccines are generally avoided while on tildrakizumab, so check with your specialist team before having any vaccination.
Does it make infections more likely?
It can raise the risk of infections, so report any fever, persistent cough or feeling unwell promptly to your team.
The wider class
About Biologic antibody for psoriasis (anti-IL-23)
Tildrakizumab belongs to the biologic antibody for psoriasis (anti-il-23) class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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