Tildrakizumab improves plaque psoriasis within 28 weeks

Key takeaways:

• By week 28, the mean percent improvement in PASI score was 82.1% from baseline.
• Body surface area involvement improved by a mean percent of 73.1% from baseline by week 28.

After 28 weeks of treatment, tildrakizumab significantly improved clinical status and reduced disease activity while also maintaining a consistent safety profile among patients with moderate to severe plaque psoriasis, according to a study.

“Although the efficacy and safety of tildrakizumab are well established in the clinical trial setting, little published real-world evidence is available from clinical practice settings,” Jayme Heim, MSN FNP-BC, of West Michigan Dermatology, and colleagues wrote. “This manuscript reports the effectiveness of tildrakizumab in terms of clinical improvement and residual disease activity, as well as safety of tildrakizumab, from the week 28 interim analysis of a 64-week phase 4 study in real-world practice.”
mean age, 48.6 years; 50.9% men; 94.5% white) received 100 mg of tildrakizumab subcutaneously at weeks 0, 4, 16 and 28.

Efficacy results, which included 52 of the 55 patients, showed that by week 28, the mean PASI score significantly decreased from 11.6 ± 7.1 at baseline to 1.8 ± 3, which was an 82.1% mean percent improvement (P < .001). Additionally, 55.8% of patients achieved PASI 90 and 21.2% achieved PASI 100 by week 28.

Body surface area involvement decreased significantly from 14.5 ± 11.5 to 2.9 ± 6.4 by week 28, which was a 73.1% mean percent improvement from baseline (P < .001). Static Physician Global Assessment (sPGA) decreased from 3.2 ± 0.6 to 1.2 ± 0.9 during this time frame as well.

When accounting for the body surface area involvement and sPGA together, the average score decreased from 47 ± 41.5 at baseline to 6.8 ± 20.3 at week 28 (P < .001).

Serious treatment-emergent adverse events were infrequent, according to the researchers, with three cases reported and one causing discontinuation. These events included one each of COVID-19 infection, cerebrovascular accident and immunoglobulin A nephropathy.

Overall, treatment-emergent adverse events occurred in 56.4% of patients; however, none were considered related to treatment, according to the study.

“This interim analysis provides information on the effectiveness and safety of tildrakizumab treatment beyond clinical trials, demonstrating the impact of treatment on clinical outcomes in patients with moderate to severe plaque psoriasis in the real-world setting,” the authors wrote. “The full 1-year results are expected to provide further insight into the safety and effectiveness of tildrakizumab in clinical practice.”