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Melgosa Ramos FJ, Mateu Puchades A, Matáix-Díaz J, Schneller-Pavelescu L, Belinchón-Romero I, Santos Alarcón S. 52-Week Mid-term Efficacy of Tildrakizumab in Moderate-to-severe Psoriasis: A Real-life Multicenter Experience. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:722-726. [PMID: 38556201 DOI: 10.1016/j.ad.2023.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 07/29/2023] [Accepted: 08/08/2023] [Indexed: 04/02/2024] Open
Abstract
Tildrakizumab is an IL-23-inhibitor that has been approved to treat plaque psoriasis. However, few reports have become available on its efficacy profile in the real-world. Our objective was to study the mid-term efficacy of tildrakizumab in patients with moderate-to-severe psoriasis in the Spanish routine clinical practice setting. This was a retrospective multicenter study that included a total of 91 psoriatic patients on tildrakizumab. The mean Psoriasis Area and Severity Index (PASI) was 9.09 (SD, 5.30). The overall tildrakizumab survival rate was 93.47% for a mean treatment exposure of 30.18 weeks (SD, 16.57). No drug discontinuation was associated with drug tolerability, or adverse reactions. Absolute PASI ≤3 was reached by 91.3% and 96.5% of the patients on weeks 28 and 52, respectively. Response was not impacted by weight, age (>65), metabolic syndrome, presence of arthritis, or previous number of biological therapies used. Based on our own experience tildrakizumab is an effective strategy to treat plaque psoriasis and difficult-to-treat-areas.
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Affiliation(s)
- F J Melgosa Ramos
- Department of Dermatology, University Hospital Doctor Peset of Valencia, Valencia, Spain.
| | - A Mateu Puchades
- Department of Dermatology, University Hospital Doctor Peset of Valencia, Valencia, Spain
| | - J Matáix-Díaz
- Department of Dermatology, Hospital Marina Alta, Vila-Joyosa, Alicante, Spain
| | | | - I Belinchón-Romero
- Department of Dermatology, General University Hospital of Alicante, Alicante, Spain
| | - S Santos Alarcón
- Department of Dermatology, University Hospital Virgen de los Lirios, Alcoy, Alicante, Spain
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Melgosa Ramos FJ, Mateu Puchades A, Matáix-Díaz J, Schneller-Pavelescu L, Belinchón-Romero I, Santos Alarcón S. 52-Week Mid-term Efficacy of Tildrakizumab in Moderate-to-severe Psoriasis: A Real-life Multicenter Experience. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:T722-T726. [PMID: 38777224 DOI: 10.1016/j.ad.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 08/08/2023] [Indexed: 05/25/2024] Open
Abstract
Tildrakizumab is an IL-23-inhibitor that has been approved to treat plaque psoriasis. However, few reports have become available on its efficacy profile in the real-world. Our objective was to study the mid-term efficacy of tildrakizumab in patients with moderate-to-severe psoriasis in the Spanish routine clinical practice setting. This was a retrospective multicenter study that included a total of 91 psoriatic patients on tildrakizumab. The mean Psoriasis Area and Severity Index (PASI) was 9.09 (SD, 5.30). The overall tildrakizumab survival rate was 93.47% for a mean treatment exposure of 30.18 weeks (SD, 16.57). No drug discontinuation was associated with drug tolerability, or adverse reactions. Absolute PASI ≤3 was reached by 91.3% and 96.5% of the patients on weeks 28 and 52, respectively. Response was not impacted by weight, age (>65), metabolic syndrome, presence of arthritis, or previous number of biological therapies used. Based on our own experience tildrakizumab is an effective strategy to treat plaque psoriasis and difficult-to-treat-areas.
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Affiliation(s)
- F J Melgosa Ramos
- Department of Dermatology, University Hospital Doctor Peset of Valencia, Valencia, España.
| | - A Mateu Puchades
- Department of Dermatology, University Hospital Doctor Peset of Valencia, Valencia, España
| | - J Matáix-Díaz
- Department of Dermatology, Hospital Marina Alta, Vila-Joyosa, Alicante, España
| | | | - I Belinchón-Romero
- Department of Dermatology, General University Hospital of Alicante, Alicante, España
| | - S Santos Alarcón
- Department of Dermatology, University Hospital Virgen de los Lirios, Alcoy, Alicante, España
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Thomas SE, Barenbrug L, Hannink G, Seyger MMB, de Jong EMGJ, van den Reek JMPA. Drug Survival of IL-17 and IL-23 Inhibitors for Psoriasis: A Systematic Review and Meta-Analysis. Drugs 2024; 84:565-578. [PMID: 38630365 PMCID: PMC11190018 DOI: 10.1007/s40265-024-02028-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND AND OBJECTIVE The most recently approved biologics for moderate-to-severe psoriasis are the interleukin (IL)-17 and IL-23 inhibitors. Drug survival is a frequently used outcome to assess drug performance in practice. An overview of the available drug survival studies regarding IL-17 and IL-23 inhibitors is lacking. Therefore, our objective was to assess the drug survival of IL-17 and IL-23 inhibitors for psoriasis. METHODS A search of PubMed, Embase, Cochrane Library and Web of Science was conducted (last search 27 December, 2023). Inclusion criteria were (1) cohort study; (2) patients aged ≥ 18 years with plaque psoriasis; and (3) evaluation of drug survival of at least one of the IL-17 and IL-23 inhibitors. Exclusion criteria were: primary focus on patients with psoriatic arthritis, fewer than ten study subjects and another language than English. The Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline was followed. Survival probabilities at monthly intervals were extracted from Kaplan-Meier curves using a semi-automated tool. Data were pooled using a non-parametric random-effects model to retrieve distribution-free summary survival curves. Summary drug survival curves were constructed per biologic for different discontinuation reasons: overall, ineffectiveness and adverse events, and split for the effect modifier biologic naivety. Results were analysed separately for registry/electronic health record data and for pharmacy/claims data. RESULTS A total of 69 studies aggregating drug survival outcomes of 48,704 patients on secukinumab, ixekizumab, brodalumab, guselkumab, risankizumab, and tildrakizumab were included. Summary drug survival estimates of registry/electronic health record studies for overall, ineffectiveness and adverse event related drug survival were high (all point estimates ≥ 0.8 at year 1) for included biologics, with highest estimates for guselkumab and risankizumab. All estimates for drug survival were higher in biologic naive than in experienced patients. Estimates of pharmacy/claims databases were substantially lower than estimates from the primary analyses based on registry/electronic health record data. CONCLUSIONS This meta-analysis showed that the investigated IL-17 and IL-23 inhibitors had high drug survival rates, with highest rates for guselkumab and risankizumab drug survival. We showed that effect modifiers such as biologic naivety, and the source of data used (registry/electronic health record data vs pharmacy/claims databases) is relevant when interpreting drug survival studies.
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Affiliation(s)
- Sarah E Thomas
- Department of Dermatology, Radboud University Medical Centre (Radboudumc), Mailbox 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Liana Barenbrug
- Department of Dermatology, Radboud University Medical Centre (Radboudumc), Mailbox 9101, 6500 HB, Nijmegen, The Netherlands
| | - Gerjon Hannink
- Department of Medical Imaging, Radboud University Medical Centre (Radboudumc), Nijmegen, The Netherlands
| | - Marieke M B Seyger
- Department of Dermatology, Radboud University Medical Centre (Radboudumc), Mailbox 9101, 6500 HB, Nijmegen, The Netherlands
| | - Elke M G J de Jong
- Department of Dermatology, Radboud University Medical Centre (Radboudumc), Mailbox 9101, 6500 HB, Nijmegen, The Netherlands
- Radboud University, Nijmegen, The Netherlands
| | - Juul M P A van den Reek
- Department of Dermatology, Radboud University Medical Centre (Radboudumc), Mailbox 9101, 6500 HB, Nijmegen, The Netherlands
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Torres T, Varela P, Mendes Bastos P, Magina S, Henrique M, Ferreira P. Tildrakizumab for the treatment of moderate-to-severe psoriasis: a 52-week, real-world Portuguese multicentric study. Drugs Context 2024; 13:2023-12-5. [PMID: 38510314 PMCID: PMC10954292 DOI: 10.7573/dic.2023-12-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/16/2024] [Indexed: 03/22/2024] Open
Abstract
Background Real-world evidence plays a pivotal role in validating the efficacy of biologic drugs beyond the controlled environment of randomized trials. This study aimed to evaluate the effectiveness of tildrakizumab in treating moderate-to-severe psoriasis within a real-world setting over a 52-week period in Portugal. Methods This multicentric, prospective, observational study included adult patients with moderate-to-severe psoriasis. All participants received tildrakizumab 100 mg at weeks 0 and 4, followed by a maintenance dose every 12 weeks, and were monitored for 52 weeks. Primary endpoints were determined based on Psoriasis Area and Severity Index (PASI) assessments at baseline, 16 (±2) weeks, 28 (±2) weeks and 52 (±2) weeks. Results A total of 54 patients were enrolled in the study (56% men, mean age of 50.3 ± 14.4 years). Half of the sample (n=27) had no prior experience with biologic treatments. About 74% of patients (n=40) presented at least one comorbidity during the study, with psoriatic arthritis being the most prevalent (29.6%). By week 52, there was a significant decrease in the mean PASI from 17.8±10.3 at baseline to 1.3±1.9 (p<0.001), indicating an overall improvement of 93%. By week 52, more than 85% of patients attained PASI ≤5, more than 80% reached PASI ≤3, and nearly 60% achieved PASI ≤1. Infections were observed in 9.3% of patients, and one patient required hospitalization (1.9%). The cumulative proportion of patients continuing treatment at 52 weeks was 88.9%. Conclusions This study demonstrates that tildrakizumab is an effective and safe agent for the treatment of moderate-to-severe psoriasis in a diverse, real-world setting.
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Affiliation(s)
- Tiago Torres
- Department of Dermatology, Centro Hospitalar Universitário de Santo António Porto, Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal
| | - Paulo Varela
- Department of Dermatology, Centro Hospitalar VN Gaia/Espinho, VN Gaia, Portugal
| | | | - Sofia Magina
- Department of Dermatology, Centro Hospitalar S. João, Porto, Portugal
- Department of Pharmacology and Therapeutics, Faculdade de Medicina, University of Porto, Porto, Portugal
| | - Martinha Henrique
- Department of Dermatology, Centro Hospitalar de Leiria, Leiria, Portugal
| | - Paulo Ferreira
- Psoriasis Unit, Hospital CUF Descobertas, Lisbon, Portugal
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Berenguer-Ruiz S, Aparicio-Domínguez M, Herranz-Pinto P, Ruíz-Villaverde R, López-Ferrer A, Santos-Juanes J, Rodríguez Fernández-Freire L, Hospital-Gil M, Arias-Santiago S, Carretero-Hernández G, Mateu-Puchades A, Ferran M, Del Alcázar E, Santos-Alarcón S, Garcia-Latasa de Aranibar FJ, Belinchón-Romero I, González-Cantero Á, Ruíz-Genao D, Eiris-Salvado N, Rocamora-Durán V, Rivera-Diaz R, de la Cueva P, Daudén E, Salgado-Boquete L, Llamas-Velasco M. Effectiveness and safety of tildrakizumab for the treatment of psoriasis in real-world settings at 24 weeks: A retrospective, observational, multicentre study by the Spanish Psoriasis Group. J Eur Acad Dermatol Venereol 2023; 37:2517-2525. [PMID: 37625815 DOI: 10.1111/jdv.19468] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 07/05/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Tildrakizumab is a humanized, IgG1/κ antibody that interacts with the p19 subunit of interleukin 23. It is approved for the treatment of moderate-to-severe plaque psoriasis. Real-world evidence on the effectiveness and safety of tildrakizumab is limited. OBJECTIVES To assess the effectiveness and safety of tildrakizumab at 24 weeks in patients with moderate-to-severe plaque psoriasis in routine clinical practice. METHODS Retrospective, observational, multicentre study including adult patients with moderate-to-severe plaque psoriasis treated with tildrakizumab under real-life conditions. Patient data were extracted from anonymized electronic medical records. Statistical analysis was performed using SPSS22. RESULTS A total of 190 patients were included. About 53.9% were men with a mean age of 51.45 (SD 3.9) and a mean BMI of 29.13 (SD 6.21). About 79.8% (132 out of 190) of patients had previously received biological therapy (BT) and 17.3% (33 out of 191) had psoriatic arthritis. Baseline PASI was 10.7 (SD 6.53). Up to 109 patients reached Week 24 and at this point mean baseline PASI decreased to 1.7 (SD 4.8), representing an 88.79% mean PASI reduction. At 6 months, 87.1% and 40.3% of the treated patients achieved PASI ≤3 and ≤1, respectively. At Week 24 mean BSA decreased from 13.2 (SD 10.07) to 1.6 (SD 4.40) and mean DLQI went from 12.5 (SD 7.12) to 1.2 (SD 3.27). Multivariate analysis showed no differences when effectiveness was correlated with gender, obesity, psoriatic arthritis or prior exposure to BT. The rate of adverse events (AE) was 5.9% (11 out of 190), where infections were the most frequent AE (4 out of 11). One patient suffered a haemorrhagic ictus and one patient died due to causes unrelated to the study. CONCLUSION Tildrakizumab was effective and safe in a large cohort of patients with moderate-to-severe plaque psoriasis treated in a routine clinical setting.
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Affiliation(s)
| | | | | | | | - Anna López-Ferrer
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Jorge Santos-Juanes
- Department of Dermatology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - Mercedes Hospital-Gil
- Department of Dermatology, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | | | | | | | - Marta Ferran
- Department of Dermatology, Hospital del Mar, Barcelona, Spain
| | - Elena Del Alcázar
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | | | | | | | | | - Diana Ruíz-Genao
- Department of Dermatology, Hospital Universitario Fundación Alcorcon, Madrid, Spain
| | - Noemí Eiris-Salvado
- Department of Dermatology, Complejo Asistencial Universitario de León, León, Spain
| | | | - Raquel Rivera-Diaz
- Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Pablo de la Cueva
- Department of Dermatology, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Esteban Daudén
- Department of Dermatology, Hospital Universitario de la Princesa, Madrid, Spain
| | | | - Mar Llamas-Velasco
- Department of Dermatology, Hospital Universitario de la Princesa, Madrid, Spain
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Risankizumab: Efficacy, Safety, and Survival in the Mid-Term (52 Weeks) in Real Clinical Practice in Andalusia, Spain, According to the Therapeutic Goals of the Spanish Psoriatic Guidelines. Life (Basel) 2022; 12:life12111883. [PMID: 36431015 PMCID: PMC9697008 DOI: 10.3390/life12111883] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/07/2022] [Accepted: 11/12/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction. Risankizumab is a humanized monoclonal antibody of the immunoglobulin G1 (IgG1) type that binds selectively, and with high affinity, to the p19 subunit of interleukin-23 (IL-23), resulting in the inhibition of inflammation and clinical symptoms associated with psoriasis. Its introduction has managed to increase the levels of efficacy and safety (improving upon those previously presented by the anti-IL-23 class). Material and methods. Retrospective analysis of a multicenter, observational study of real clinical practice, including patients with moderate-to-severe plaque psoriasis in treatment with risankizumab. This cross-sectional analysis includes information on patients from May 2020 to June 2022. A total of six tertiary hospitals in Andalusia (Spain) participated in this study. Analyses were performed “as observed” using GraphPad Prism version 8.3.0 for Windows. Results. Regarding the percentage of patients who reached PASI 90 or PASI 100 at week 52, 92.5% achieved the therapeutic goal of PASI 90, and 78.5% reached PASI 100. When analyzing the results by absolute PASI, we found that 78.5% (n = 33) obtained PASI 0, 85.7% (n = 36) obtained PASI ≤ 1, and all patients achieved PASI ≤ 3 (disease control). Discussion. Risankizumab has shown promising results in the control of psoriasis in the long-term, with a high percentage of patients (>80%) maintaining PASI 90 and PASI 100 up to 52 weeks of treatment. No abnormal safety findings have been reported, and risankizumab appears to be a solid treatment in the different scenarios analyzed.
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