Treatment Patterns, Drug Survival, and Effectiveness of Tildrakizumab Among Patients with Prior Interleukin-17 Experience in the PPD CorEvitas Psoriasis Registry

INTRODUCTION: Tildrakizumab is an interleukin (IL)-23 p19 inhibitor approved for the treatment of adults with moderate-to-severe plaque psoriasis. This study assessed tildrakizumab effectiveness and drug survival in real-world patients with prior IL-17 inhibitor (IL-17i) experience. METHODS: Patients initiated tildrakizumab (October 2018 to April 2024) at or after enrollment in the PPD™ CorEvitas™ Psoriasis Registry, an independent observational cohort of patients with psoriasis under dermatologist care in North America. Outcomes included drug survival from Kaplan-Meier analysis and changes from baseline in clinician- and patient-reported outcomes, including Psoriasis Area Severity Index (PASI), Dermatology Life Quality Index (DLQI), and patient-reported symptoms at 12 (± 3) months. RESULTS: Of 728 tildrakizumab initiators, 186 (25.5%) had prior IL-17i experience. Their mean age was 56.9 years; 54.3% were female, 137 (73.7%) had prior use of ≥ 2 biologics, including ≥ 1 IL-17i at any time, and 115 (61.8%) used an IL-17i immediately prior to tildrakizumab initiation. Over half (55.4%) had psoriatic arthritis at baseline. Baseline mean PASI was 6.0 (standard deviation [SD] (6.2) and mean DLQI was 7.2 (SD (6.8). The restricted mean tildrakizumab survival time was 27.4 months; 56.8% of initiators were persistent at 12 months. Improvements at 12 months were seen for PASI (mean 2.4, SD 4.8) and DLQI (mean 2.6, SD 5.7); 57.9%, 40.4%, and 38.9% of patients achieved PASI ≤ 3, PASI ≤ 1, and DLQI 0/1, respectively. Improvements in fatigue, skin pain, and itch were also observed. CONCLUSIONS: As measured by clinician- and patient-reported outcomes, tildrakizumab was effective in real-world patients in North America with extensive prior biologic experience including immediate prior IL-17i experience. The majority of IL-17i-experienced initiators persisted on treatment for at least 1 year.