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Taltz: 7 things you should know

Medically reviewed by Carmen Fookes, BPharm. Last updated on Oct 12, 2020.

1. How it works

  • Taltz is a brand (trade) name for ixekizumab, a medication that may be used to treat psoriasis, psoriatic arthritis, ankylosing spondylitis, and some other conditions.
  • Taltz works by binding to interleukin 17A (IL-17A) which is a pro-inflammatory cytokine produced by T-helper cells. IL-17A mediates innate immunity (natural immunity) to infecting substances and it can also contribute to the development of chronic diseases characterized by inflammation, such as psoriasis and rheumatoid arthritis. Taltz stops IL-17A from interacting with the IL-17 receptor, which prevents inflammation.
  • Taltz belongs to the class of medicines called interleukin inhibitors. It may also be called a monoclonal antibody.

2. Upsides

  • Taltz may be used to reduce symptoms of moderate to severe plaque psoriasis in adults and children over the age of 6, active psoriatic arthritis in adults, and ankylosing spondylitis in adults.
  • After an initial loading dose (which varies depending on what Taltz is being administered for), Taltz is usually given once a month by subcutaneous injection (under the skin).
  • People prescribed Taltz can be taught how to self administer it by a healthcare professional.
  • Taltz is effective at reducing symptoms of plaque psoriasis in adults and children over the age of 6, active psoriatic arthritis in adults, and ankylosing spondylitis in adults.
  • Taltz has few side effects, although it may increase the risk of infection.
  • Taltz is available as the Taltz Autoinjector and the Taltz prefilled syringe.

3. Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

  • Injection site reactions (pain, redness, and swelling at the injection site), nausea, neutropenia (low levels of a type of white blood cell), thrombocytopenia (low platelet levels), and infections are the most common side effects reported with Taltz.
  • Infections are more likely to occur with Taltz because it affects the immune system, reducing its ability to respond to pathogens. The most common infections reported include upper respiratory tract infections, conjunctivitis, tinea, and oral candidiasis. Some of these infections can become serious. Taltz should not be started in people who have symptoms of an infection, and your doctor may decide to discontinue Taltz, either temporarily or permanently, if you develop an infection while being administered Taltz.
  • Before starting Taltz, your doctor will ask you if you have been exposed to tuberculosis (TB) in the past. They may need to do some further tests and may require you to undertake a course of antibiotics if their investigations show you have been exposed to TB. If you develop symptoms of TB (such as a persistent cough lasting longer than three weeks, chest pain, coughing up blood or sputum), tell your doctor immediately.
  • Serious hypersensitivity reactions (such as angioedema and urticaria) have been reported in 0.1% of people administered Taltz. A health professional should always administer the first dose of Taltz and patients should be advised to seek urgent emergency help if they experience an allergic-type reaction.
  • People being treated with Taltz are at a higher risk of developing inflammatory bowel disease. Symptoms may include diarrhea, abdominal pain, fever, blood in the stool, or weight loss.
  • Taltz is only available as an injection which is administered under the skin. It must be stored in the refrigerator before use. You should remove Taltz from the refrigerator 30 to 60 minutes before you intend to administer it to ensure that it has reached room temperature, which reduces the risk of it stinging when you administer it. Taltz can remain out of the refrigerator for up to four hours.
  • The dosage of Taltz in children aged 6 to 18 with plaque psoriasis is based on their weight.
  • It is unknown what effect Taltz has during pregnancy on the unborn child. There are no data on the effect of Taltz during lactation.

Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects

4. Bottom Line

Taltz is a monoclonal antibody that reduces inflammation and may be used to treat conditions such as psoriasis, psoriatic arthritis, or ankylosing spondylitis. It is given by injection just under the skin, and the main side effects are injection site reactions and an increased risk of infection.

5. Tips

  • If you have been shown how to self-inject Taltz, administer yourself a dose once every month, preferably on the same day of the month, otherwise see your healthcare provider for a dose every month. If you forget a dose, schedule it in for as soon as you can, then continue with your regular dosing schedule.
  • Immediately before administration take one Taltz injection out of the refrigerator and leave on a flat surface, away from children and pets, to warm up to room temperature for around 30 minutes. Do not warm in any other way (such as by putting in hot water). Taltz at room temperature reduces the risk of stinging. Inspect the injection for any discoloration or particulate matter and do not use if the liquid is cloudy, contains particles, or is discolored. The liquid in Taltz should be clear, colorless, or have a slightly yellow tinge. Check the expiry date on the side of the injection and do not use Taltz if it has expired. Do not shake Taltz.
  • Taltz is best administered into the front of your thighs or the lower part of your abdomen, avoiding the area around your belly button (stay and inch away from your belly button). If somebody else is giving you your injection they can also administer it into the outer area of your upper arm. Change your injection site each month so that you are not injecting into the same spot each time.
  • Only inject into clear, healthy skin. Do not inject into any areas that are bruised, tender, red, scaly, or hard. You should also not inject into any scars, stretch marks, or areas of psoriasis.
  • If you feel pain when you inject Taltz, placing an ice pack on the area of skin where you inject Taltz for a few minutes before and after the injection can help reduce this pain.
  • Do not shake the Taltz Autoinjector before use. Wash your hands then clean the injection site with an alcohol wipe and let the area dry. Check that the lock ring is in the lock position and then twist off the base cap in the direction of arrows. Hold the clear base flat and firmly against your skin at the chosen injection site. Turn the lock ring to the unlock position, and when ready, activate the injection by pressing the green injection button. You should hear a loud click. Keep holding the Autoinjector against the skin until you hear a second click about 10 seconds later which tells you the injection is complete. You should be able to see the gray plunger at the top of the clear base. Dispose of the used Taltz autoinjector in an approved sharps container.
  • Store Taltz in the refrigerator. Once taken out of the refrigerator, use within four hours. If you have not used it within this time throw it away. Do not put Taltz back in the refrigerator if it has been out of the refrigerator for more than a few minutes. Do not freeze Taltz. Protect Taltz from light.
  • Seek urgent medical attention if you experience shortness of breath, facial or throat tightness after administering Taltz. If you feel unwell, or experience other signs of infection, tell your doctor immediately. Also remember to tell your doctor about any other side effects that you may be experiencing, such as dizziness or fainting.
  • Taltz is associated with a higher risk of developing inflammatory bowel disease. Report any symptoms such as diarrhea, abdominal pain, fever, blood in the stool, or weight loss to your doctor.
  • Tell other health professionals that you are being administered Taltz. Before you start Taltz, all your vaccinations should be up to date. While you are receiving Taltz, you should not receive any live vaccines (such as the MMR vaccine or the chickenpox vaccine).
  • Taltz is not recommended during pregnancy unless the benefits outweigh the risks but tell your doctor immediately if you become pregnant while being administered Taltz.
  • Talk to your doctor or pharmacist before taking any other medicines with Taltz.

6. Response and Effectiveness

  • Results from trials of 12 weeks duration investigating the effectiveness of Taltz in plaque psoriasis showed that 87% to 90% of people achieved a PASI 75, which is the proportion of subjects with at least a 75% reduction in their Psoriasis Area and Severity Index (PASI) composite score. 68% to 71% achieved a PASI 90 and 35% to 40% achieved a PASI 100.
  • In addition, 81% to 83% achieved a static Physician Global Assessment (sPGA) of “0” (clear) or “1” (minimal) with Taltz after 12 weeks compared to 3% to 7% of those assigned placebo (a pretend injection).
  • For people with psoriatic arthritis, 57% of participants achieved an ACR20 (20% improvement in tender and swollen joint counts) by week 12 and 58% achieved an ACR20 by week 24. 34% of participants achieved an ACR50 (50% improvement in tender and swollen joint counts) by week 12 and 40% achieved an ACR50 by week 24. 15% of participants achieved an ACR70 (70% improvement in tender and swollen joint counts) by week 12 and 23% achieved an ACR70 by week 24.
  • For ankylosing spondylitis, 64% achieved an Assessment of Spondyloarthritis International Society 20 (ASAS20) response at Week 16, and 48% achieved an ASAS40 response at Week 16.
  • Taltz starts working within a week with noticeable improvements usually seen after 4 weeks. It may take up to 24 weeks to see the maximal response.

7. Interactions

Medicines that interact with Taltz may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with Taltz. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.

Common medications that may interact with Taltz include:

  • aminophylline
  • anticonvulsants, such as phenobarbital,
  • benzodiazepines, such as alprazolam or clonazepam
  • chemotherapy agents, such as cyclophosphamide, methotrexate, or bleomycin
  • corticosteroids (such as prednisone or dexamethasone)
  • cyclosporine
  • heart medications such as amiodarone or flecainide
  • herbals, such as echinacea
  • hormones such as levonorgestrel or norgestrel
  • immunosuppressants (such as azathioprine, cyclosporine, or tacrolimus)
  • live vaccines and some other vaccines, such as BCG, cholera, measles, or hepatitis b vaccines
  • opioids, such as fentanyl or oxycodone
  • other biologics, such as adalimumab, golimumab, or infliximab
  • probiotics, such as lactobacillus
  • statins, such as atorvastatin or simvastatin
  • theophylline
  • warfarin
  • zinc.

There is a potential for any medication that is metabolized by CYP450 enzymes, particularly those with a narrow therapeutic index (such as cyclosporine or warfarin) to interact with Taltz. This is because the formation of CYP450 enzymes can be altered by increased levels of certain cytokines (such as IL-1, IL-6, IL-10, Il-17) during chronic inflammation. Because Taltz stops IL-17A from interacting with the IL-17 receptor, this could normalize the formation of CYP450 enzymes. Monitor for any change in effect and consider any dosage modification.

Note that this list is not all-inclusive and includes only common medications that may interact with Taltz. You should refer to the prescribing information for Taltz for a complete list of interactions.

References

Taltz (ixekizumab). Revised 05/2020. Eli Lilly and Company. https://www.drugs.com/pro/taltz.html

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Taltz only for the indication prescribed.

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