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Introduction <p>Psoriasis is a chronic immune-mediated disease with significant systemic implications. Tildrakizumab, an IL-23p19 inhibitor, has demonstrated efficacy in moderate-to-severe plaque psoriasis. Higher doses may be beneficial for patients with elevated body weight or greater disease burden. This study evaluates the effectiveness of tildrakizumab 200&#xa0;mg in a real-world setting, analyzing outcomes based on weight, Psoriasis Area Severity Index (PASI), body mass index (BMI), and prior biologic exposure.</p> Methods <p>A multicenter retrospective study was conducted across 10 Italian hospitals. Adult patients (≥ 18&#xa0;years) with moderate-to-severe plaque psoriasis treated with tildrakizumab 200&#xa0;mg for ≥ 36&#xa0;weeks were included. Patients were stratified by weight (≥ 90&#xa0;kg vs. &lt; 90&#xa0;kg), BMI (≥ 30 vs. &lt; 30), PASI (≥ 15 vs. &lt; 15), and biologic history (naïve vs. biologic (bio)-experienced). PASI100 response rates at 36&#xa0;weeks were assessed. Statistical analyses included Fisher’s exact test (<i>p</i> &lt; 0.05 significant).</p> Results <p>Among 137 patients, PASI100 response rates were 67.1% for patients &lt; 90&#xa0;kg vs. 49.2% for ≥ 90&#xa0;kg (<i>p</i> = 0.04), 61.5% for PASI &lt; 15 vs. 50% for PASI ≥ 15 (<i>p</i> = 0.03), and 60.8% for bio-naïve vs. 57.1% for bio-experienced (<i>p</i> = 0.08). BMI ≥ 30 was associated with lower PASI100 (44.2%) compared to BMI &lt; 30 (61.4%) (<i>p</i> = 0.05). Despite subgroup differences, all patients exhibited clinical improvement.</p> Conclusion <p>Tildrakizumab 200&#xa0;mg effectively treated moderate-to-severe psoriasis across diverse patient subgroups. While higher weight and PASI were associated with slightly lower PASI100 rates, significant improvements were observed, supporting its role in difficult-to-treat patients.</p>

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Effectiveness of Tildrakizumab 200 mg in Moderate-to-Severe Plaque Psoriasis: A Multicenter Real-World Study Analyzing Patient Outcomes by Weight, PASI, BMI, and Previous Therapies

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月24日

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  • Emanuele Trovato,
  • Tommaso Bianchelli,
  • Giulia Odorici,
  • Aldo Cuccia,
  • Vito Giuseppe Di Lernia,
  • Claudia Lasagni,
  • Marco Manfredini,
  • Massimiliano Nicolini,
  • Giulia Rech,
  • Francesca Satolli,
  • Alessandra Cartocci,
  • Federico Bardazzi,
  • Anna Campanati

摘要

Introduction

Psoriasis is a chronic immune-mediated disease with significant systemic implications. Tildrakizumab, an IL-23p19 inhibitor, has demonstrated efficacy in moderate-to-severe plaque psoriasis. Higher doses may be beneficial for patients with elevated body weight or greater disease burden. This study evaluates the effectiveness of tildrakizumab 200 mg in a real-world setting, analyzing outcomes based on weight, Psoriasis Area Severity Index (PASI), body mass index (BMI), and prior biologic exposure.

Methods

A multicenter retrospective study was conducted across 10 Italian hospitals. Adult patients (≥ 18 years) with moderate-to-severe plaque psoriasis treated with tildrakizumab 200 mg for ≥ 36 weeks were included. Patients were stratified by weight (≥ 90 kg vs. < 90 kg), BMI (≥ 30 vs. < 30), PASI (≥ 15 vs. < 15), and biologic history (naïve vs. biologic (bio)-experienced). PASI100 response rates at 36 weeks were assessed. Statistical analyses included Fisher’s exact test (p < 0.05 significant).

Results

Among 137 patients, PASI100 response rates were 67.1% for patients < 90 kg vs. 49.2% for ≥ 90 kg (p = 0.04), 61.5% for PASI < 15 vs. 50% for PASI ≥ 15 (p = 0.03), and 60.8% for bio-naïve vs. 57.1% for bio-experienced (p = 0.08). BMI ≥ 30 was associated with lower PASI100 (44.2%) compared to BMI < 30 (61.4%) (p = 0.05). Despite subgroup differences, all patients exhibited clinical improvement.

Conclusion

Tildrakizumab 200 mg effectively treated moderate-to-severe psoriasis across diverse patient subgroups. While higher weight and PASI were associated with slightly lower PASI100 rates, significant improvements were observed, supporting its role in difficult-to-treat patients.