Aim:
Tildrakizumab, commonly known as Ilumya, is a monoclonal antibody that selectively targets interleukin-23 (IL-23), a cytokine that plays an important role in mediating severe psoriasis. Through the reSURFACE 1 and 2 trials, tildrakizumab exhibited positive therapeutic efficacy and was shown to be well tolerated for moderate-to-severe psoriasis for at least three years. The purpose of this study is to demonstrate the real world efficacy of tildrakizumab on a cohort of patients with psoriasis at a large tertiary centre in Australia.
Methods:
We performed a single-centre retrospective review of all patients who had received tildrakizumab therapy for chronic plaque psoriasis at a major tertiary hospital in Melbourne, Australia.
Results:
In total 13 patients were identified. The mean age was 56.5 years. Gender predisposition was Male:Female 1.2:1. Plaques were most commonly found on the extremities (92%), head/neck excluding face (85%), and trunk (62%). Hypertension (39%) and hypercholesterolaemia (23%) were key comorbidities. Topical corticosteroids (85%), phototherapy (38%), acitretin (38%), cyclosporin (31%), and methotrexate (31%) were the most common therapies prior to biological therapy. Mean baseline PASI score (SD) was 2.7 (6.4). Twelve patients (92%) were commenced on tildrakizumab as the first biological treatment, the remaining patient started on secukinumab for 3 months before commencing tildrakizumab. Most patients (10, 77%) were commenced on a 100mg 3 monthly regimen, of whom 7 (70%) have continued treatment with good effect. Tildrakizumab was used for an 11.8 average doses, and mean therapy duration of 22.8 months among patients who ceased therapy. No adverse effects from treatment were reported.
Conclusions:
Tildrakizumab is a well tolerated and effective therapy for chronic plaque psoriasis. In an ever-evolving biological treatment landscape, further research is needed to identify the type of patients who may best benefit from this therapy.