Tildrakizumab proves effective as treatment for scalp psoriasis

Key takeaways:

• At week 16, 49.4% of the tildrakizumab group achieved clearance or near clearance of their scalp psoriasis vs. 7.3% of placebo.
• Adverse events occurred in 35% of the tildrakizumab group vs. 21.1% of placebo.

Tildrakizumab was efficacious in the treatment of patients with moderate to severe plaque psoriasis affecting the scalp and presented no new safety signals, according to a study.

“Approximately 40% to 90% of patients with psoriasis have scalp involvement,” Kurt Gebauer, MBBS, FACD, FACP, director at Fremantle Dermatology in Australia, and colleagues wrote. “Scalp psoriasis is associated with significant erythema, scaling and pruritus and can be psychologically and socially distressing.”

Gebauer and colleagues presented results from a week 16 primary analysis of a randomized, double-blind, placebo-controlled phase 3b study evaluating the efficacy and safety of tildrakizumab (Ilumya, Sun Pharma), an interleukin-23 inhibitor, for the treatment of moderate to severe plaque psoriasis of the scalp.

Patients aged 18 years or older with a clinical diagnosis of chronic plaque psoriasis for 6 months or longer received tildrakizumab 100 mg (n = 89) or placebo (n = 82) at baseline and week 4.

Results showed that a significantly higher proportion of patients treated with tildrakizumab vs. placebo achieved the primary endpoint of an IGA modified 2011 (scalp) score of clear or almost clear with at least a 2-point reduction from baseline at week 16 (49.4% vs. 7.3%; P < .00001). This was also seen at week 12 (46.1% vs. 4.9%; P < .00001).

Psoriasis Scalp Severity Index 90 was achieved by 48.3% and 2.4% of patients treated with tildrakizumab and placebo, respectively, at week 12 and by 60.7% and 4.9% at week 16 (both, P < .00001).

Treatment-emergent adverse events were reported in 35% of patients treated with tildrakizumab and 21.1% of patients treated with placebo. The most frequent adverse events among the tildrakizumab group were upper respiratory tract infection, nasopharyngitis and hypertension, whereas the most common among the placebo group were headache and diarrhea.

One serious adverse event of sciatica was reported in a tildrakizumab-treated patient; however, it was considered unrelated to treatment.

“Tildrakizumab 100 mg is efficacious and improves patient-reported scalp itch and quality of life compared with placebo, with no new safety signals, in patients with moderate to severe psoriasis affecting the scalp,” the authors concluded.