Although some people with plaque psoriasis can control their symptoms by using topical treatments that are applied to the skin, some people with moderate or severe plaque psoriasis do not get enough benefit from these treatments. In these cases, medicines that are taken by mouth or injected into the body may be needed. These medicines act directly on the body’s immune system to help reduce symptoms.
One of these medicines, Taltz, was approved for the treatment of moderate or severe plaque psoriasis in 2016. Clinical research shows that this injectable medicine may work better than some of the other injectable medicines that have been approved for this same purpose in the past.
How Does Taltz Work for Plaque Psoriasis?
Plaque psoriasis, the most common form of psoriasis, is a type of autoimmune condition where the body’s immune cells attack its own healthy cells. In people with plaque psoriasis, the immune system attacks healthy skin cells, which causes swelling (inflammation). This can make too many skin cells form on the skin, causing discolored patches. These patches, which are known as “plaques,” are sections of thick, raised skin that may be covered with a thin, silvery-white scale.
For many people, these plaques will be itchy and uncomfortable. But it is important not to scratch the itchy areas, since scratching can cause the plaques to get bigger and thicker. Plaques most often appear on the scalp, elbows, knees, and lower back, although some people may get plaques on other parts of the body as well.
People with plaque psoriasis have “flare-ups,” or times when their symptoms are most noticeable. These flare-ups can last weeks or even months. Many “triggers” can make psoriasis worse or cause a flare-up, including certain medicines. An infection, such as a cold or the flu, can also trigger a flare-up. Some other common triggers include:
- Dry or cold weather
- Stress
- Skin injuries, such as cuts or severe sunburns
- Smoking
- Drinking large amounts of alcohol
For most people, the key to treating plaque psoriasis is to avoid triggers, moisturize the skin, and apply topical treatments as prescribed. But this does not always work for people with very bad symptoms. People with more severe plaque psoriasis may need more treatments that target the body’s overactive immune system.
Taltz is a medicine called a biologic that blocks the effect of a substance called interleukin-17A (IL-17A). This substance is normally made by your body and is part of your body’s response to inflammation. Blocking this substance can help treat the symptoms of plaque psoriasis.
What Should I Do Before Starting Treatment?
Taltz affects the immune system and may increase your risk of infections. Do not use Taltz if you have any signs of infection. Your health care provider will check you for tuberculosis (TB) before you start Taltz and will watch you closely during and after treatment. If you have TB or had it in the past, you may need to be treated before you start Taltz.
Your health care provider will review your vaccination record and recommend any vaccines you may need before starting Taltz. You should not receive any live vaccines while you are using Taltz. Live vaccines include measles, mumps, rubella (MMR) and chickenpox. Talk to your health care provider if you are planning on getting any vaccines. Your health care provider will determine if this is a live vaccine and can advise you if or when you can get it.
How Do I Use Taltz?
Taltz is a liquid injected under the skin. In adults, the medicine is given once every two weeks for the first 12 weeks, and then once every four weeks. In children, the medicine is given once every four weeks.
Taltz is injected into the thigh or stomach area by you or a caregiver. A caregiver may also inject the medicine into the back of the arm. Do not inject into areas of the skin that are tender, bruised, red, or hard, or in an area that has psoriasis. Each injection should be given at a different site. Do not inject within 1 inch around your belly button.
Taltz comes in two forms. The most common form is a prefilled injection device that is ready to use, so you do not need to learn how to use a syringe and needle. The medicine also comes in a prefilled syringe with a needle. In either case, if your health care provider decides you can give your injections at home, they will give you instructions and teach you how to give yourself or your child the injection. The medicine is stored in the refrigerator. To make the injection more pleasant, it is helpful to let it warm up to room temperature before using it.
It is important to inject the medicine properly so that you get the right dose. Your prescription should come with “Instructions for Use,” which explains how to prepare and give a dose. Ask your pharmacist or other health care provider if you are unsure how to use Taltz. If you miss a dose of Taltz, give a dose as soon as you remember. Thereafter, you can continue to administer doses at your regularly scheduled time.
How Was Taltz Studied in Adults?
For plaque psoriasis in adults, three studies known as UNCOVER-1, UNCOVER-2, and UNCOVER-3 were completed to see if Taltz was better than a placebo (containing no medicine) at reducing the severity of psoriasis after 12 weeks. In UNCOVER-2 and UNCOVER-3, Taltz was also compared to another medicine that treats psoriasis, etanercept (Enbrel). People in these studies were between 32 and 58 years old, with plaque psoriasis involving at least 10% of body surface area, and moderate to severe plaque psoriasis (about 50% had severe or very severe disease). Of the people in the studies, 44% had prior light therapy, 49% had tried by-mouth medicines, and 26% had tried an injection medicine for psoriasis. Twenty-three percent had a history of psoriatic arthritis.
Taltz was better than placebo in all three studies, with up to 90% of people treated with Taltz seeing a 75% improvement of psoriasis plaques and about 40% of people treated with Taltz having completely clear skin at week 12. In comparison, only 2% to 7% of people treated with placebo saw a 75% improvement of psoriasis plaques, and 0% to 1% of people treated with a placebo noted completely clear skin at week 12. An extension of the study showed that these results continued to be seen for up to 60 weeks, with at least 50% of people maintaining or achieving complete clearance of their psoriasis. Taltz was also better than etanercept at reducing psoriasis plaque severity and achieving clearer skin after 12 weeks.
Another study looked at Taltz compared to placebo in people with plaque psoriasis in the genital area that did not respond to topical therapy (medicines applied to the skin) and were candidates for light therapy and/or oral or injection medicines for psoriasis. Most of the people in this study were men (about 75%), between 30 and 56 years old, and had plaque psoriasis involving at least 10% of their body surface area. Between 86% to 89% of people in the study were White; other races included were not described. At the start of the study, just under half of the people included had psoriasis severity scores that classified their psoriasis as severe or very severe. Psoriasis of the genitals was also classified as severe or very severe in 42% of people at the beginning of the study. The goal of the study was to see how many people who received Taltz were able to improve their psoriasis severity scores to classify their genital psoriasis as clear or almost clear after 12 weeks of treatment compared to people who received placebo. At 12 weeks, 73% of people who received Taltz could classify their genital psoriasis as clear or almost clear, compared to 8% of people who received placebo and 55% of people had a considerable reduction in genital itching compared to 6% of people who used placebo.
Your results may differ from what was seen in clinical studies.
How Was Taltz Studied in Children?
For plaque psoriasis in children, there was a study called IXORA-Peds that compared Taltz to placebo. Children in this study were between 6 and less than 18 years old with an average age of 13 years old. There were more females (58%) than males (42%). Most children were White (84%). Other races included in the study were American Indian or Alaska Native (<2%), Asian (3.5%), Black or African American (3% to 6%), and people with multiple races (6% to 9%). Children in the study had moderate to severe plaque psoriasis involving at least 10% of their body surface area. Of the children in the studies, 22% had prior light therapy, 32% had tried medicines taken by mouth, and 4% had tried an injection medicine for psoriasis. The main purpose of the study was to see if Taltz was better than placebo at improving psoriasis in children and adolescents, as measured by a 75% improvement of the Psoriasis Area and Severity Index (PASI) severity score and a separate score showing their psoriasis as clear or almost clear at week 12. In this study, 89% of children who used Taltz saw a 75% improvement of psoriasis plaques at 12 weeks compared to 25% who used a placebo medicine, and 81% of children using Taltz achieved a score indicating clear or almost clear disease compared to 11% using a placebo medicine. Improvement in itch severity was seen in 71% of children who received Taltz compared to 20% who received a placebo. An extension of the study showed that people who had significant improvement of psoriasis plaques at week 12 maintained those improvements for up to 2 years with continued treatment.
How Long Does It Take to Work?
If Taltz is working, your symptoms will start to improve over the first few weeks. Most people see the greatest improvements during the second and third months of taking the medicine.
Do not stop using this or any other medicines for plaque psoriasis without talking to your health care provider first, even if your symptoms have gotten better. Your symptoms may get worse again if you stop or change any of your medicines.
Tell your health care provider if your symptoms do not seem to be improving after about two to three months of using Taltz. Your health care provider may discuss other options for treating this condition.
What Are the Side Effects, and How Can I Manage Them?
Taltz can cause a skin reaction where the shot goes in, which may involve redness and pain. One way to reduce these reactions is to inject the medicine into a different part of the body each time, which is called rotating the injection site. For example, it can be injected into different parts of the thigh, stomach, or outer area of the upper arms. Don’t inject the drug into a psoriasis plaque or any skin that is already tender, damaged, bruised, or scarred.
People who use Taltz are more likely to have infections, especially an infection of the airways. These include infections in the nose or throat, a sore throat, or common cold symptoms. The best way to prevent infection is to reduce your exposure to germs by washing your hands and avoiding people who are sick. You should also stay current on vaccinations, such as getting an annual flu vaccine. Before you start Taltz, speak with your health care professional about whether you are due for any vaccines.
Taltz may cause allergic reactions in some people, which can be serious. These include feeling faint, swelling of your face, eyelids, lips, mouth, tongue, or throat, trouble breathing or chest tightness, or a skin rash. Stop using Taltz and get help right away if you have any symptoms of a serious allergic reaction.
Some people who use Taltz may have a severe skin reaction that looks like eczema. This can happen from days to months after your first dose of Taltz, and you may need to be treated in a hospital if this happens. Your health care provider may need to stop treatment if you develop severe skin reactions. Call your health care provider if you develop a severe skin reaction.
These are not all of the possible side effects. Talk with your health care provider if you are having symptoms that bother you. If you experience anything that you think may be caused by Taltz, you can also report side effects to the FDA at 800-FDA-1088 (800-332-1088).
Is There Any Cost Assistance Available?
There is a cost savings and support program offered by the manufacturer that may help you save money on your Taltz prescription. Your health care provider can help you to get started with this program. You can also find out more by calling 844-TALTZ-NOW (844-825-8966) or by visiting taltz.lilly.com/savings-support.
