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Published on: March 1, 2024
Real-World Effectiveness of Tildrakizumab for Moderate-to-Severe Plaque Psoriasis in Canada
Mohannad Abu-Hilal1, Jeff Cowger2, Mohammed Bawazir3,4,5
1Division of Dermatology, McMaster University, Hamilton, ON, Canada.
Background:
Tildrakizumab is an interleukin-23 inhibitor approved in Canada in 2021 for the treatment of adults with moderate-to-severe plaque psoriasis.
Objectives:
To evaluate real-world effectiveness of tildrakizumab for the treatment of moderate-to-severe plaque psoriasis in Canada.
Methods:
A multicenter, retrospective study was conducted in Canada in adults with moderate-to-severe plaque psoriasis for ≥1 year treated with tildrakizumab for ≥12 weeks. Effectiveness was evaluated from proportions of patients achieving ≥75%/≥90%/100% improvement from baseline in Psoriasis Area and Severity Index (PASI 75/90/100 response) and Physician Global Assessment (PGA) 0 or 1 at weeks 16 (±4), 24 (±8), and 48 (±12). Subgroup analyses were performed based on prior biologic use and special site involvement.
Results:
The study included 75 patients (mean age, 50.5 years; 52.0% female; 82.7% bio-naïve; 73.3% with special site involvement). Absolute mean (standard deviation) PASI score improved from 16.1 (6.7) at baseline to 1.3 (1.7) at the week 48 (91.7% improvement), 95.7%/69.6%/34.8% of patients achieved PASI 75/90/100 response, and 93.0% achieved PGA 0/1 at the week 48. In subgroup analyses, 94.7%/71.1%/34.2% of bio-naïve patients, 100.0%/62.5%/37.5% of bio-experienced patients, 100.0%/71.4%/28.6% of patients with special site involvement, and 81.8%/63.6%/54.6% of patients without special site involvement achieved PASI 75/90/100 response, and 87.5%, 94.3%, 97.0%, and 80.0% of patients, respectively, achieved PGA 0/1 at the week 48. None of the differences among subgroups were statistically significant; however, patient numbers were too small to support robust conclusions.
Conclusions:
Tildrakizumab is effective for the treatment of moderate-to-severe plaque psoriasis in adults in a real-world setting in Canada.

