A long‐term study of tildrakizumab treatment in patients with psoriasis

Linked Article:   Thaçi et al. Br J Dermatol 2021; 185 :323–334. Psoriasis, a common skin condition causing red and scaly patches of skin, affects about 2% of people worldwide. We wanted to see how effective and safe the drug tildrakizumab is for long‐term psoriasis treatment. We gathered information from two clinical trials, reSURFACE 1 and reSURFACE 2. Patients with psoriasis were treated with tildrakizumab dosed at 100 mg or 200 mg for 5 years. We measured severity of psoriasis signs and symptoms using the Psoriasis Area and Severity Index (PASI). Treatment success was measured a number of ways and one was the proportions of patients achieving PASI 75 or PASI 90 response, meaning a 75% or 90% reduction in their PASI score from the start of treatment. We have previously reported that high proportions of patients treated with tildrakizumab achieved a PASI 75 response during the first year of treatment. We found that improvement was maintained with continued tildrakizumab treatment. Of patients with PASI 75 response on either tildrakizumab dose after 28 weeks, 91% achieved PASI 75 and 68% achieved PASI 90 responses after 5 years. In patients who did not respond or only partially responded to etanercept – another psoriasis treatment –and who switched to tildrakizumab 200 mg, 81% achieved PASI 75 and 50% achieved PASI 90 responses after 5 years. Very few undesirable effects and no new or unexpected side‐effects were reported. The most frequent side‐effect was nasopharyngitis (the common cold). Severe infections, malignancies, and heart or blood vessel disease were uncommon and did not increase with continuous treatment or higher dosing of tildrakizumab. In conclusion, tildrakizumab was found to be a safe and effective treatment for psoriasis for up to 5 years.