TOPLINE:

In a real-world multicentre study, tildrakizumab demonstrated sustained clinical effectiveness through 100 or 112 weeks with favourable safety outcomes in patients with moderate-to-severe plaque psoriasis.

METHODOLOGY:

• Researchers conducted a multicentre, retrospective observational study across five tertiary hospitals in the Basque Country, Northern Spain, including 212 adult patients (median age, 52.7 years; 56.6% men) with moderate-to-severe plaque psoriasis (median duration, 20.9 years) between November 2020 and April 2024.
• All patients were eligible for systemic therapy and received 100 or 200 mg of tildrakizumab subcutaneously at weeks 0 and 4, followed by dosing every 12 weeks. More than 80% of patients had previously received biologic therapy before starting tildrakizumab.
• Efficacy was evaluated using Psoriasis Area and Severity Index (PASI), Body Surface Area (BSA), and Physician Global Assessment (PGA) scores at baseline and at weeks 28, 52, 76, and 100 or 112, along with assessments of safety and treatment discontinuation.

TAKEAWAY:

• Disease severity decreased over time, with an increasing percentage of patients achieving PASI improvements at 28 weeks (PASI75, 60.0%; PASI90, 42.9%; PASI100, 28.6%), 52 weeks (PASI75, 66.4%; PASI90, 44.2%; PASI100, 31.0%), and 76 weeks (PASI75, 67.4%; PASI90, 44.2%; PASI100, 32.6%). At 100 or 112 weeks, the percentages achieving PASI75 and PASI90 remained high (55% and 45%, respectively), whereas the percentage achieving PASI100 decreased slightly (25%).
• Skin involvement decreased substantially from 28 weeks (mean BSA score, 5.6%), was lowest at 52 weeks (mean BSA score, 3.5%), and remained low at 76 weeks (mean BSA score, 3.8%) and 100 or 112 weeks (mean BSA score, 3.4%) compared with the disease burden at baseline (mean BSA score, 18.6%).
• Additionally, physician-assessed disease severity decreased from baseline (mean PGA score, 3.05) to 28 weeks (mean PGA score, 1.22), reached its lowest at 76 weeks (mean PGA, 0.90), and remained low at 100 or 112 weeks (mean PGA score, 1.20).
• Treatment was discontinued in 41 patients, primarily due to primary or secondary failure and patient decision. No serious treatment-related adverse events or deaths occurred during the follow-up period.

IN PRACTICE:

"Our study confirms that tildrakizumab is an effective and safe therapeutic option for moderate-to-severe psoriasis in routine clinical practice, even in heavily pretreated patients and those with significant comorbidities," the authors wrote. "These findings contribute valuable evidence to the growing real-world literature on tildrakizumab and support its positioning as a reliable long-term therapy," they concluded.

SOURCE:

The study was led by Rosa Izu-Belloso, Department of Dermatology, Basurto University Hospital, Bilbao, Spain. It was published online on December 05, 2025, in Dermatology and Therapy.

LIMITATIONS:

The retrospective design and partial data availability at later timepoints may have introduced selection bias. The study lacked patient-reported outcome measures such as the Dermatology Life Quality Index. The last observation carried forward approach used for handling missing data carried inherent methodological limitations.

DISCLOSURES:

This study received no funding or sponsorship. The Rapid Service Fee was funded by the authors with research funds obtained by the team and deposited in the Biobizkaia Health Research Institute. The authors declared having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.