REAL-WORLD meta-analysis found tildrakizumab substantially improved plaque psoriasis severity and quality of life through 52 weeks.
Real World Evidence for Tildrakizumab
Plaque psoriasis is a chronic inflammatory skin disease that can substantially impair quality of life. In a systematic literature review and meta-analysis, researchers evaluated real world outcomes with tildrakizumab in adults with chronic moderate-to-severe plaque psoriasis, including effectiveness, patient-reported quality of life, and safety. The analysis also assessed how findings compared with other IL-23 p19 inhibitors, including guselkumab and risankizumab.
The investigators searched MEDLINE and Embase on November 16, 2023, and also reviewed meeting abstracts from 2021–2023 and bibliographies of prior reviews. Eligible studies reported real world use of tildrakizumab in adults, either as single-arm evidence or in comparative designs. Outcomes included disease severity measures, such as Psoriasis Area and Severity Index, Physician’s Global Assessment, and percent body surface area affected, alongside Dermatology Life Quality Index scores and safety events.
Improvements Through One Year
Across 37 studies representing 45 publications, pooled results indicated marked improvements from baseline through 36–52 weeks of follow-up. Mean absolute Psoriasis Area and Severity Index decreased from 12.81 at baseline to 1.62 by 36–52 weeks, while percent body surface area affected declined from 16.21% to 3.27% over the same period. Physician’s Global Assessment also improved, shifting from a mean of 3.18 at baseline to 0.70 at 36–52 weeks.
Quality of life improved in parallel. Dermatology Life Quality Index scores decreased from a mean of 14.59 at baseline to 1.83 by 36–52 weeks, reflecting a substantial reduction in psoriasis-associated burden as captured in the included real-world studies.
Safety and Comparative Findings
Reported rates of adverse events, serious adverse events, treatment-related adverse events, and withdrawals due to adverse events were low in the pooled analysis. In comparative assessments, benefits and safety outcomes with tildrakizumab were reported as similar to guselkumab and risankizumab. The authors noted that real world evidence can be affected by study heterogeneity and potential bias, and should be interpreted with appropriate caution.
Reference: Gottlieb S et al. Real-World Benefit of Tildrakizumab for Moderate-to-Severe Plaque Psoriasis: Findings from a Systematic Literature Review and Meta-Analysis. Dermatology and Therapy. 2026;doi:10.1007/s13555-025-01625-6.
