Faculty: Lindsay S. Ackerman, MD
For the Fall Conference afternoon product theater, Dr. Lindsay Ackerman discussed Ilumya for the management of moderate to severe plaque psoriasis. She reviewed the growth of biologics in the field of psoriasis management since 2004. Dr. Ackerman encouraged providers to have a conversation with their patients in order to choose the right medication for each psoriasis patient. Ilumya is an interleukin-23 (IL23) antagonist indicated for the treatment of adults with moderate-to-severe plaque psoriasis who are candidates for systemic therapy or phototherapy. Dr. Ackerman reports that she likes to explain IL23 inhibition as a way to “stop the inflammatory cascade at an early point in the process”.
Ilumya has a durable safety profile that is well tolerated with a low rate of adverse events. The most common adverse events are upper respiratory infection, injection site reaction and diarrhea. Patients who use Ilumya may be at an increased risk for developing infections and treatment with Ilumya should not be initiated in any patient who has an infection. Additionally, there have been reports of non-life threating angioedema and urticaria in patients who use Ilumya.
Dr. Ackerman reports that she likes to explain IL23 inhibition as a way to “stop the inflammatory cascade at an early point in the process”.
One of the benefits of Ilumya is infrequent dosing with subcutaneous injections at weeks 0, 4 and every 12 weeks thereafter. This medication is administered in the office by a medical provider. PASI (psoriasis area and severity index) scores are graded based on plaque location, evaluation of erythema and thickness of plaques. For patients who use Ilumya, PASI scores reveal very limited residual disease. Lastly, all patients should be screened for tuberculosis prior to initiating therapy and live vaccines should be avoided in patients who are using Ilumya.