Tildrakizumab drug survival: can we really attribute the benefit to male sex?

We read with considerable interest the recent retrospective, multicentre international study published in Clinical and Experimental Dermatology that reports 36-month drug survival rates for tildrakizumab in 517 adult patients with plaque psoriasis. These data add valuable real-world insights to the interleukin-23 inhibitor evidence base and support the long-term utility of tildrakizumab in routine clinical practice; however, two key methodological considerations merit further scrutiny.