Real-World Treatment Patterns of Patients With Psoriasis Treated With Tildrakizumab in the United States

OBJECTIVES: Psoriasis (PsO) is a chronic autoimmune disease causing accelerated growth cycles of skin cells. Tildrakizumab is an anti-interleukin-23 (IL-23) p19 antagonist indicated for PsO and real-world evidence on tildrakizumab treatment patterns is limited. This study aimed to assess persistence, adherence, and use of other biologics among PsO patients treated with tildrakizumab.

METHODS: This retrospective, longitudinal, descriptive cohort study utilized data from IQVIA PharMetrics® Plus, a large United States (US) claims database, January 2011-December 2022. Adults with ≥2 PsO diagnoses on distinct dates, ≥2 claims for tildrakizumab, ≥3 months of continuous eligibility before and after first tildrakizumab claim (index date), and <180 days between their first 2 tildrakizumab claims were selected. Study outcomes were measured from index to end of continuous clinical activity or data availability (follow-up), and included adherence (proportion of days covered [PDC]), time to treatment discontinuation (TTD), persistence, and proportion of patients using other biologics after tildrakizumab initiation.

RESULTS: Among 538 eligible patients, the mean age was 49.4 years old (standard deviation [SD] ± 13.4 years); 61.7% of patients were naïve to biologic treatments at index; and 24.7% of patients had used apremilast before tildrakizumab. Mean PDC was 90.7% (SD ± 10.0%) and 84.6% of patients were adherent to tildrakizumab (PDC ≥80%). Median tildrakizumab TTD (95% confidence interval) was 13.0 (11.7, 14.9) months and 52.7% persistently remained on tildrakizumab at 12 months from initiation. Over a mean follow-up period of 18.1 months (SD ± 11.8 months), 76.2% patients did not use other PsO-approved biologics after tildrakizumab.

CONCLUSIONS: This study found high adherence and persistence to tildrakizumab in a large nationally representative US claims database. Most patients did not use other biologics after tildrakizumab, indicating that switching to other biologics is infrequent. Future research is needed to compare treatment patterns of tildrakizumab and other biologic treatments for PsO.