Real-world Tildrakizumab Effectiveness and Drug Survival: A Cohort Study in the PPD CorEvitas Psoriasis Registry

INTRODUCTION: Tildrakizumab is an interleukin-23 p19 inhibitor approved for the treatment of adults with moderate-to-severe plaque psoriasis. While clinical trials have demonstrated tildrakizumab efficacy, studies reporting real-world treatment patterns and outcomes for tildrakizumab initiators in North America are needed. METHODS: This analysis included patients who initiated tildrakizumab (October 2018 to April 2024) at or after enrollment in the PPD™ CorEvitas™ Psoriasis Registry, an independent observational study of patients with psoriasis under dermatologic care. Drug survival was analyzed using Kaplan-Meier analysis. Effectiveness was assessed by changes from baseline to 12 (± 3) months in outcomes, including Psoriasis Area Severity Index (PASI), Dermatology Life Quality Index (DLQI), and patient-reported skin pain, itch, and fatigue (scales, 0-100). Results were presented overall and by prior experience with biologic treatments. RESULTS: There were 728 tildrakizumab initiators with mean age 58.4, mean PASI 7.7 (standard deviation [SD] 7.3), mean DLQI 7.3 (SD 6.2), and mean patient-reported skin pain, itch, and fatigue scores of 29.7 (SD 32.5), 46.0 (SD 34.4), and 32.3 (SD 29.4), respectively; 47.7% were female, and 383 (52.6%) were biologic-experienced. Restricted mean drug survival for all, biologic-naïve, and biologic-experienced initiators with follow-up was 35.2, 43.3, and 29.5 months, respectively; overall 12-month persistence was 72.8%. Patients with 12 months follow-up (n = 330) had mean improvements from baseline in PASI (4.9, SD 7.0), DLQI (3.9, SD 5.9), and skin pain (mean 13.1, SD 29.9), itch (mean 22.1, SD 34.7), and fatigue (mean 6.7, SD 29.1); 71.3% and 52.9% achieved PASI ≤ 3 and ≤ 1, respectively. CONCLUSIONS: Based on clinician- and patient-reported outcomes and a mean drug survival of almost 3 years, tildrakizumab was effective among real-world patients with plaque psoriasis.