A choice for patients with plaque PsO and for patients with PsA
Week 12 results
In Clinical Trials of Patients with Moderate to Severe Plaque Psoriasis
For adults with moderate to severe plaque psoriasis
Taltz can provide high levels of clearance—even complete resolution of plaques (PASI 100) is possible1
In UNCOVER-2, 83% of patients taking Taltz achieved sPGA 0,1 vs 2% who received placebo.
Additional Results
In UNCOVER-1 (Taltz n=433; placebo n=431) and UNCOVER-3 (Taltz n=385; placebo n=193), Taltz patients achieved similar results: 89% and 87% of Taltz patients achieved PASI 75 respectively vs 4% and 7% for placebo. Additionally, 71% and 68% of Taltz patients achieved PASI 90 vs 1% and 3% for placebo, and 35% and 38% achieved PASI 100 vs 0% and 0% for placebo. Also, 82% and 81% achieved sPGA 0,1 vs 3% and 7% for placebo.
In the 3 pivotal trials, examination of age, gender, race, body weight, and previous treatment with a biologic did not identify differences in response to Taltz among these subgroups at week 12.1
Taltz is the first and only interleukin-17A (IL-17A) antagonist approved for moderate to severe plaque psoriasis that includes PASI 100 in the Prescribing Information.1
Select Important Safety Information
Infections
Taltz may increase the risk of infection. In clinical trials of patients with plaque psoriasis, the Taltz group had a higher rate of infections than the placebo group (27% vs 23%). A similar increase in risk of infection was seen in placebo-controlled trials of patients with psoriatic arthritis. Serious infections have occurred. Instruct patients to seek medical advice if signs or symptoms of clinically important chronic or acute infection occur. If a serious infection develops, discontinue Taltz until the infection resolves.
In Clinical Trials of Patients with Moderate to Severe Plaque Psoriasis
In UNCOVER-2, the average change in PASI was 91% at week 122
In UNCOVER-1, the mean percentage improvement in PASI at week 12 was 85% in the Taltz group compared to 0% in the placebo group. In UNCOVER-3, the mean percentage improvement in PASI at week 12 was 91% in the Taltz group compared to 14% in the placebo group.
The comparison of mean percent change in PASI using LOCF (last observation carried forward) at each study week between treatments is based on an analysis of covariance.
Evaluate patients for tuberculosis (TB) infection prior to initiating treatment with Taltz. Do not administer to patients with active TB infection. Initiate treatment of latent TB prior to administering Taltz. Closely monitor patients receiving Taltz for signs and symptoms of active TB during and after treatment.
In Clinical Trials of Patients with Moderate to Severe Plaque Psoriasis
Taltz showed superiority in 2 head-to-head trials vs US-approved etanercept1
Results from US sites.
*US-approved etanercept.
In integrated UNCOVER-2 and -3, 73% of patients taking Taltz achieved clear or almost clear skin (sPGA 0,1) vs 27% who received etanercept.
adverse events and discontinuation rates for taltz compared to us-approved etanercept
The rate of serious adverse events during the controlled induction period (weeks 0-12) was 0.7% for US-approved etanercept and 2% for Taltz and the rate of discontinuation from adverse events was 0.7% for US-approved etanercept and 2% for Taltz. The incidence of infections was 18% for US-approved etanercept and 26% for Taltz. The rate of serious infections was 0.3% for both US-approved etanercept and Taltz.
In Clinical Trials of Patients with Moderate to Severe Plaque Psoriasis
Taltz provided high levels of efficacy compared to placebo at week 12 regardless of previous treatment with a biologic1,3
*Patients were classified as biologic-experienced if they had received prior treatment with at least 1 biologic agent.
NRI=nonresponder imputation.
In these trials, 83% of biologic-naive and 80% of biologic-experienced patients receiving Taltz achieved sPGA 0,1 vs 5% and 2%, respectively, for patients receiving placebo.
In the placebo group, biologic-naive (n=535) and biologic-experienced (n=257) patients achieved PASI 75 rates of 5% and 3%, PASI 90 rates of 2% and 0%, and PASI 100 rates of 0% and 0%, respectively.
Serious hypersensitivity reactions, including angioedema and urticaria (each ≤0.1%), occurred in the Taltz group in clinical trials. Anaphylaxis, including cases leading to hospitalization, has been reported in post-marketing use with Taltz. If a serious hypersensitivity reaction occurs, discontinue Taltz immediately and initiate appropriate therapy.
Efficacy You Can See
In Clinical Trials of Patients with Moderate to Severe Plaque Psoriasis
See the difference Taltz can make in 12 weeks4-7
Psoriasis can impact all areas of the body. The following images are of real adult patients with moderate to severe psoriasis who were treated with Taltz over a 12-week period. The photos at baseline and week 12 can be viewed below by dragging the slider right or left.
DRAG TO VIEW PATIENT AT BASELINE (PASI SCORE=19.2)
DRAG TO VIEW PATIENT AT WEEK 12 (PASI SCORE=2.8)
Click to zoom inout
Click to zoom inout
Copying, downloading, or other use of patient photos is expressly prohibited.
Trial B was a phase 3b, double-arm, open-label study examining disease severity of Taltz-treated patients with moderate to severe plaque psoriasis through patient- and physician-reported clinical measures. The trial used sequential photographic images to support clinical measurements with visual representations of improvements in disease severity. All patients received a starting dose of 160 mg of Taltz, and then received 80 mg of Taltz every 2 weeks through week 12 (n=6).
Week 60 Results
In Clinical Trials of Patients with Moderate to Severe Plaque Psoriasis
Reassure your patients* that consistent results can be maintained with Taltz at week 601
Of the patients who completed 60 weeks of treatment without relapse (sPGA ≥3) or discontinuation (n=147), 92% maintained clear or almost clear skin (sPGA 0,1) at week 60 based on an observed analysis.
Patients who achieved clear or almost clear skin (sPGA 0,1) after initial treatment with Taltz 80 mg every 2 weeks were re-randomized at week 12 to receive either Taltz 80 mg every 4 weeks (n=181) or placebo (n=203).
During Taltz treatment, monitor patients for onset or exacerbation of inflammatory bowel disease. Crohn’s disease and ulcerative colitis, including exacerbations, occurred at a greater frequency in the Taltz group (Crohn’s disease 0.1%, ulcerative colitis 0.2%) than in the placebo group (0%) during clinical trials in patients with plaque psoriasis.
Week 156 Results
In Clinical Trials of Patients with Moderate to Severe Plaque Psoriasis
PASI 75, PASI 90, and PASI 100 results at weeks 60, 108, and 1568*
Induction Period and Open-Label Extension
Patient and site personnel were blinded to study treatment until all patients completed week 12 or discontinued. The open label extension phase of the study has limitations (eg, no placebo comparison, patients remaining in the extension phase may be those with better results).
Analyses from UNCOVER-3, outcomes through week 156 mNRI and observed are post-hoc.
*A subset of moderate to severe plaque psoriasis patients from UNCOVER-3 who received a 160 mg starting dose of Taltz at week 0, followed by 80 mg every 2 weeks through week 12, followed by 80 mg every 4 weeks.
†Nx=observed population at week 156.
mNRI=modified nonresponder imputation.
In an mNRI analysis of patients receiving Taltz at week 60, 89% of patients achieved PASI 75, 77% of patients achieved PASI 90, and 57% of patients achieved PASI 100. In an mNRI analysis of patients receiving Taltz at weeks 108 and 156, 84% and 81% of patients achieved PASI 75, 69% and 66% of patients achieved PASI 90, and 48% and 45% of patients achieved PASI 100. mNRI of intent-to-treat population through week 156. mNRI analysis imputes missing data due to study drug (eg, inadequate response, adverse event, or lack of efficacy) as nonresponse; whereas, missing data due to other reasons (eg, missed visits, lost to follow up) is included as a predicted value based on statistical modeling of observed data.
Taltz [package insert]. Indianapolis, IN: Eli Lilly and Company; 2017.
Data on file. Lilly USA, LLC. TAL20160223C.
Data on file. Lilly USA, LLC. TAL20160328C.
Data on file. Lilly USA, LLC. TAL20160222D.
Data on file. Lilly USA, LLC. TAL20160222A.
Data on file. Lilly USA, LLC. TAL20160222E.
Data on file. Lilly USA, LLC. TAL20160222B.
Data on file. Lilly USA, LLC. TAL20171023A.
ACR at week 24
In Clinical Trials of Patients with Active Psoriatic Arthritis
FOR BIOLOGIC-NAIVE PATIENTS WITH PSORIATIC ARTHRITIS
Taltz provided significant improvement in joint symptoms at week 24, as measured by ACR201-3
Primary endpoint=ACR20 response at week 24.
Nonresponder imputation (NRI) of intent-to-treat population through week 52. After Week 24, patients knew they were taking active treatment, but remained blind to the dose until the last patient completed week 24. The uncontrolled extension period of the study has limitations (eg, no placebo comparisons, patients remaining in the study may be those with better results).
Inadequate responders (<20% improvement in tender and in swollen joint counts) at week 16 were analyzed as nonresponders after week 16 until the primary endpoint.
In SPIRIT-P2 (TNFi-experienced) (Taltz 80 mg every 4 weeks n=122; placebo n=118), 53% of patients receiving Taltz achieved ACR20 at week 24 vs 20% for placebo. Additionally, 35% and 22% of Taltz patients achieved ACR50 and ACR70, respectively, at week 24 vs 5% and 0%, for placebo.1
ACR20/50/70=American College of Rheumatology 20%/50%/70% response rate.
Taltz may increase the risk of infection. In clinical trials of patients with plaque psoriasis, the Taltz group had a higher rate of infections than the placebo group (27% vs 23%). A similar increase in risk of infection was seen in placebo-controlled trials of patients with psoriatic arthritis. Serious infections have occurred. Instruct patients to seek medical advice if signs or symptoms of clinically important chronic or acute infection occur. If a serious infection develops, discontinue Taltz until the infection resolves.
In Clinical Trials of Patients with Active Psoriatic Arthritis
FOR TNFi-EXPERIENCED PATIENTS WITH PSORIATIC ARTHRITIS
Taltz provided significant improvement in joint symptoms at week 24 in patients who had an intolerance to or failed 1 or 2 TNF inhibitors1
Primary endpoint=ACR20 response at week 24.
Nonresponder imputation (NRI) of intent-to-treat population through week 24.
Inadequate responders (<20% improvement in tender and in swollen joint counts) at week 16 were analyzed as nonresponders after week 16 until the primary endpoint.
In SPIRIT-P1 (biologic-naive) (Taltz 80 mg every 4 weeks n=107, placebo n=106), 58% of patients receiving Taltz achieved ACR20 at week 24 vs 30% for placebo. Additionally, 40% and 23% of patients receiving Taltz vs 15% and 6% of those receiving placebo achieved ACR50 and ACR70, respectively, at week 24.1
ACR20/50/70=American College of Rheumatology 20%/50%/70%; TNFi=tumor necrosis factor inhibitor; NRI=nonresponder imputation.
Taltz may increase the risk of infection. In clinical trials of patients with plaque psoriasis, the Taltz group had a higher rate of infections than the placebo group (27% vs 23%). A similar increase in risk of infection was seen in placebo-controlled trials of patients with psoriatic arthritis. Serious infections have occurred. Instruct patients to seek medical advice if signs or symptoms of clinically important chronic or acute infection occur. If a serious infection develops, discontinue Taltz until the infection resolves.
Acr through week 108
In Clinical Trials of Patients with Active Psoriatic Arthritis
FOR BIOLOGIC-NAIVE PATIENTS WITH PSORIATIC ARTHRITIS
ACR response through week 1085
Inadequate responders (<20% improvement in tender and in swollen joint counts) at week 16 were analyzed as nonresponders after week 16 until the primary endpoint.
After week 24, patients knew they were taking active treatment, but remained blind to the dose until the last patient completed week 24. The uncontrolled extension period of the study has limitations (eg, no placebo comparisons, patients remaining in the study may be those with better results).
*Nx=observed population at week 108. Nx values are different due to missing data.
In a modified nonresponder imputation (mNRI) analysis of patients receiving Taltz: at week 52, 76% of patients achieved ACR20, 60% of patients achieved ACR50, and 40% of patients achieved ACR70; at week 108, 70% of patients achieved ACR20, 51% of patients achieved ACR50, and 30% of patients achieved ACR70.
mNRI of intent-to-treat population through week 108. mNRI, a preferred method for analyzing long-term efficacy, imputes missing data due to study drug (eg, inadequate response, adverse event, or lack of efficacy), as nonresponse; whereas, missing data due to other reasons (eg, missed visits, lost to follow-up) is included as a predicted value based on statistical modeling of observed data.
Evaluate patients for tuberculosis (TB) infection prior to initiating treatment with Taltz. Do not administer to patients with active TB infection. Initiate treatment of latent TB prior to administering Taltz. Closely monitor patients receiving Taltz for signs and symptoms of active TB during and after treatment.
Radiographic Response
In Clinical Trials of Patients with Active Psoriatic Arthritis
For BIOLOGIC-NAIVE PATIENTS WITH PSORIATIC ARTHRITIS
Taltz inhibited progression of structural joint damage in patients at week 16 vs placebo1,6
Primary endpoint=ACR20 response at week 24.
Inhibition of progression of structural damage was assessed radiographically and expressed as the mean change in mTSS and its components, the joint space narrowing score and bone erosion score, at week 16 vs baseline. The mTSS score was modified for psoriatic arthritis by addition of hand distal interphalangeal (DIP) joints.
mTSS=modified Total Sharp Score; MMRM=mixed-effect model of repeated measure.
SPIRIT-P2 (TNFi-experienced) did not include an assessment of radiographic progression.4
Taltz [package insert]. Indianapolis, IN: Eli Lilly and Company; 2017.
Mease PJ, van der Heijde D, Ritchlin CT, et al; on behalf of SPIRIT-P1 Study Group. Ixekizumab, an interleukin-17A specific monoclonal antibody, for the treatment of biologic-naive patients with active psoriatic arthritis: results from the 24-week randomised, double-blind, placebo-controlled and active (adalimumab)-controlled period of the phase III trial SPIRIT-P1. Ann Rheum Dis. 2017;76:79-87.
van der Heijde D, Gladman D, Kishimoto M, et al. Efficacy and safety of ixekizumab in patients with active psoriatic arthritis: 52-week results from a phase 3 study (SPIRIT-P1). J Rheumatol. 2018;45:3. doi:10.3899/jrheum.170429.
Nash P, Kirkham B, Okada M, et al; on behalf of SPIRIT-P2 Study Group. Ixekizumab for the treatment of patients with active psoriatic arthritis and an inadequate response to tumour necrosis factor inhibitors: results from the 24-week randomised, double-blind, placebo-controlled period of the SPIRIT-P2 phase 3 trial. Lancet. 2017;389:2317-2327.
Data on file. Lilly USA, LLC. TAL20171017A.
Data on file. Lilly USA, LLC. TAL20171026B.
Indication and Important Safety Information
Psoriatic Arthritis:
Taltz is indicated for the treatment of adult patients with active psoriatic arthritis.
Plaque Psoriasis:
Taltz is indicated for the treatment of adult patients with moderate to severe plaque psoriasis who are candidates for systemic therapy or phototherapy.
IMPORTANT SAFETY INFORMATION
Contraindications
Taltz is contraindicated in patients with a previous serious hypersensitivity reaction, such as anaphylaxis, to ixekizumab or to any of the excipients.
Warnings and Precautions
Infections
Taltz may increase the risk of infection. In clinical trials of patients with plaque psoriasis, the Taltz group had a higher rate of infections than the placebo group (27% vs 23%). A similar increase in risk of infection was seen in placebo-controlled trials of patients with psoriatic arthritis. Serious infections have occurred. Instruct patients to seek medical advice if signs or symptoms of clinically important chronic or acute infection occur. If a serious infection develops, discontinue Taltz until the infection resolves.
Pre-Treatment Evaluation for Tuberculosis
Evaluate patients for tuberculosis (TB) infection prior to initiating treatment with Taltz. Do not administer to patients with active TB infection. Initiate treatment of latent TB prior to administering Taltz. Closely monitor patients receiving Taltz for signs and symptoms of active TB during and after treatment.
Hypersensitivity
Serious hypersensitivity reactions, including angioedema and urticaria (each ≤0.1%), occurred in the Taltz group in clinical trials. Anaphylaxis, including cases leading to hospitalization, has been reported in post-marketing use with Taltz. If a serious hypersensitivity reaction occurs, discontinue Taltz immediately and initiate appropriate therapy.
Inflammatory Bowel Disease
During Taltz treatment, monitor patients for onset or exacerbations of inflammatory bowel disease. Crohn’s disease and ulcerative colitis, including exacerbations, occurred at a greater frequency in the Taltz group (Crohn’s disease 0.1%, ulcerative colitis 0.2%) than in the placebo group (0%) during clinical trials in patients with plaque psoriasis.
Immunizations
Prior to initiating therapy with Taltz, consider completion of all age-appropriate immunizations according to current immunization guidelines. Avoid use of live vaccines in patients treated with Taltz.
Adverse Reactions
Most common adverse reactions (≥1%) associated with Taltz treatment are injection site reactions, upper respiratory tract infections, nausea, and tinea infections. Overall, the safety profile observed in patients with psoriatic arthritis was consistent with the safety profile in patients with plaque psoriasis, with the exception of influenza and conjunctivitis.
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By using the Taltz Savings Card ("Card"), you attest that you meet the eligibility criteria and will comply with the Terms and Conditions described below:
Offer void where prohibited by law. This offer is invalid for patients without commercial insurance coverage or those whose prescription claims are eligible to be reimbursed, in whole or in part, by any governmental program, including, without limitation, Medicaid, Medicare, Medicare Part D, Medigap, DOD, VA, TRICARE/CHAMPUS, or any state patient or pharmaceutical assistance program. If you live in Massachusetts, the Card expires on the earlier of: (i) the expiration date of this card (12/31/2021); (ii) the date an AB-rated generic equivalent for Taltz becomes available; or (iii) June 30, 2019, absent a change in Massachusetts state law. If you live in California, the card expires on the earlier of: (i) the expiration date of this card (12/31/2021) or (ii) the date an FDA approved therapeutically equivalent for Taltz or over the counter product with the same active ingredients becomes available. Available only in the US and Puerto Rico for residents of the US and Puerto Rico.
By accepting this offer, you agree that if you are required to do so under the terms of your insurance coverage for this prescription or are otherwise required to do so by law, you should notify your insurance carrier of your redemption of this Card. This offer is not valid with any other program, discount, incentive, or similar offer involving Taltz. It is prohibited for any person to sell, purchase, or trade; or to offer to sell, purchase or trade; or to counterfeit this Card. This offer may be terminated, rescinded, revoked or amended by Lilly USA, LLC, at any time without notice. This Card is not health insurance. This Card expires on 12/31/2021. Patients must first use their card by 12/31/2018 and are eligible for savings for up to 36 months of therapy.
UNCOVER-1, -2, and -3 Trial Design
The Taltz plaque psoriasis clinical program included 3 randomized, double-blind, placebo-controlled trials to evaluate the efficacy and safety of Taltz. All patients were ≥18 years of age and had plaque psoriasis with a body surface area involvement of ≥10%, a static Physician’s Global Assessment (sPGA) score ≥3, and a Psoriasis Area Severity Index (PASI) score ≥12, and were candidates for phototherapy or systemic therapy. Participants were randomized to receive placebo or Taltz 80 mg every 2 weeks following a 160 mg starting dose. In UNCOVER-2 and -3, an additional arm of US-approved etanercept (50 mg twice weekly) was included. Co-primary efficacy endpoints were proportion of patients with an sPGA 0,1 and at least a 2-point improvement from baseline and proportion of patients achieving PASI 75 (at least a 75% reduction in the PASI composite score) at week 12. Nonresponder imputation (NRI) methods were used for categorical efficacy analyses.
Patients originally randomized to Taltz who were responders at week 12 (ie, sPGA 0,1) in UNCOVER-1 and -2 were re-randomized to either Taltz 80 mg every 4 weeks or placebo for an additional 48 weeks. Patients who relapsed (sPGA ≥3) at any time during the maintenance period were classified as nonresponders at week 60.
SPIRIT-P1 and -P2 Trial Design
SPIRIT-P1 (N=417) and SPIRIT-P2 (N=363) were phase 3, randomized, double-blind, placebo-controlled trials to evaluate the efficacy and safety of Taltz compared with placebo in patients with active psoriatic arthritis. Patients in SPIRIT-P1 were biologic-naive. Patients in SPIRIT-P2 were TNFi-experienced, having had an inadequate response and/or intolerance to 1 or 2 prior TNF inhibitors. In both trials, the primary efficacy endpoint was the proportion of patients achieving ACR20 response at week 24. All patients were ≥18 years of age and had ≥3 swollen and ≥3 tender joints. Patients were randomized to placebo or Taltz 80 mg every 2 or 4 weeks following a 160 mg starting dose. In SPIRIT-P1, an active reference arm of adalimumab 40 mg every 2 weeks was included. Patients in all study arms were allowed to continue taking stable background medications during the trial. Inadequate responders (as defined by blinded criteria of <20% improvement in tender and in swollen joint counts) at week 16 received rescue therapy and were analyzed as nonresponders after week 16 until the primary endpoint. After receiving rescue therapy, inadequate responders in the placebo and adalimumab arms were re-randomized to Taltz 80 mg every 2 or 4 weeks. Nonresponder imputation (NRI) methods were used for categorical efficacy analyses during the double-blind treatment period.
*Pay no more than $25 monthly and as little as $5 monthly. $5 Monthly offer subject to a maximum annual benefit of $16,000. $25 Monthly offer subject to a monthly and annual cap of usual and customary pharmacy charges. If you meet program eligibility requirements, have commercial insurance, and your insurance provider covers Taltz, you are eligible to pay $5 monthly. If you meet program eligibility requirements, have commercial insurance, and your insurance provider denies coverage for Taltz after 2 requests for coverage attempts, you are eligible to pay $25 monthly. To participate in the $25 monthly program, eligible patients will need to contact Taltz Together to verify eligibility. To continue to participate in the $25 program, patients who qualify for the $25 monthly program are required to have a new benefits investigation and request for coverage completed 3 months post program initiation, 6 months post program initiation, and then every 6 months thereafter, as well as in January of every year, to verify coverage status and potential eligibility for the $5 monthly program. Card activation for both the $5 and $25 monthly programs is good for up to 24 months from patient qualification into the program. Subject to the terms and conditions of the program, patients may be eligible to re-enroll provided they continue to meet program criteria.
†Eligibility Criteria: By using the Taltz Savings Card (“Card”), you attest that you meet the eligibility criteria and will comply with the Terms and Conditions described below:
Offer void where prohibited by law. This offer is invalid for patients without commercial insurance coverage or those whose prescription claims are eligible to be reimbursed, in whole or in part, by any governmental program, including, without limitation, Medicaid, Medicare, Medicare Part D, Medigap, DOD, VA, TRICARE/CHAMPUS, or any state patient or pharmaceutical assistance program. If you live in Massachusetts, the Card expires on the earlier of: (i) the expiration date of this Card (December 31, 2018); (ii) the date an AB-rated generic equivalent for Taltz becomes available; or (iii) July 1, 2017, absent a change in Massachusetts state law. Available only in the US and Puerto Rico for residents of the US and Puerto Rico.
By accepting this offer, you agree that if you are required to do so under the terms of your insurance coverage for this prescription or are otherwise required to do so by law, you should notify your insurance carrier of your redemption of this Card. This offer is not valid with any other program, discount, incentive, or similar offer involving Taltz. It is prohibited for any person to sell, purchase or trade; or to offer to sell, purchase or trade; or to counterfeit this Card. This offer may be terminated, rescinded, revoked, or amended by Lilly USA, LLC, at any time without notice. This Card is not health insurance. This Card expires on 12/31/2018. Patients must first use their Card by 12/31/2016 and are eligible for savings for up to 24 months of therapy.
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