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Becher G, Conner S, Ingram JA, Stephen KE, McInnes AC, Heald AH, Riley PA, Davies M, Domenech A, Kasujee I. A Retrospective Real-World Study of the Effectiveness and Tolerability of Tildrakizumab in UK Adults with Moderate-to-Severe Chronic Plaque Psoriasis. Dermatol Ther (Heidelb) 2022; 12:2343-2354. [PMID: 36076145 PMCID: PMC9458480 DOI: 10.1007/s13555-022-00800-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 08/19/2022] [Indexed: 11/03/2022] Open
Abstract
Introduction As with most medicines historically, clinicians prescribing tildrakizumab have relied on information derived from registration studies undertaken in a prospective controlled clinical trial setting. More recently, clinicians, policymakers, and commissioners increasingly rely on real-world data to inform both policy and practice. Methods A retrospective real-world data study was undertaken at four specialist dermatology departments in the United Kingdom. All adult patients treated with tildrakizumab for moderate-to-severe plaque psoriasis were included, with data being collected for 122 patients. Results Psoriatic patients on tildrakizumab tended to be overweight (median body mass index of 32 (range 19–59) (n = 61); 26/68 (38%) < 90 kg, 32/68 (47%) between 90 and 120 kg, and 10/68 (15%) > 120 kg). The study population had high levels of comorbidities (83/116, 72%), multiple special sites (39/117, 33%), and histories of biological treatments (81/100, 81%). Most patients (61/80, 76%) initiated on tildrakizumab were switched from another biological treatment. Tildrakizumab was effective, with 91/122 (75%) patients remaining on treatment for the duration of the study—a median of 12 months per patient (range 1–29 months)—and achieving a change in median Psoriasis Area and Severity Index (PASI) from 12 to 0.35 and in Dermatology Life Quality Index (DLQI) from 20 to 0. The response rate was 57/66 (86%) when tildrakizumab was used as the first- or second-line biologic compared to 19/31 (61%) when used as the third- to seventh-line. Thirty-three (78.6%) patients over 90 kg of weight received the 200-mg dose of tildrakizumab. All but one (n = 8) patient with body weight over 120 kg maintained response over time. There was one treatment discontinuation; a patient who had a local sensitivity reaction. Conclusions In UK clinical practice, tildrakizumab was well tolerated and effective at doses of 100 mg or 200 mg in a range of patient phenotypes.
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Affiliation(s)
- Gabrielle Becher
- West Glasgow Ambulatory Care Hospital, NHS Greater Glasgow and Clyde, Glasgow, Scotland, UK
| | - Sophia Conner
- West Glasgow Ambulatory Care Hospital, NHS Greater Glasgow and Clyde, Glasgow, Scotland, UK
| | - Jennifer A Ingram
- Department of Dermatology, The Princess Alexandra Hospital NHS Trust, Harlow, England, UK
| | - Karen E Stephen
- Department of Dermatology, NHS Tayside, Dundee, Scotland, UK
| | - Alison C McInnes
- Dermatology Unit, Royal Cornwall Hospitals NHS Trust, Truro, England, UK
| | - Adrian H Heald
- School of Medical Sciences, Manchester University, Manchester, England, UK
| | - Paul A Riley
- Res Consortium, Fosse House, East Anton Court, Icknield Way, Andover, SP10 5RG, England, UK
| | - Mark Davies
- Res Consortium, Fosse House, East Anton Court, Icknield Way, Andover, SP10 5RG, England, UK
| | - Arnau Domenech
- Almirall SA, Ronda General Mitre, 151, 08022, Barcelona, Spain
| | - Ismail Kasujee
- Almirall SA, Ronda General Mitre, 151, 08022, Barcelona, Spain.
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