OBJECTIVES : This study aimed to address the comparative effectiveness of IL-23p19 inhibitors ILUMETRI® (tildrakizumab) and TREMFYA® (guselkumab), indicated for the treatment of moderate-to-severe plaque psoriasis. We report results of an indirect comparison to compare tildrakizumab 100 mg (dosed per approved label on weeks 0, 4 and every 12 weeks thereafter) and guselkumab 100 mg.

METHODS : We conducted a systematic literature review and Bucher indirect comparison of tildrakizumab and guselkumab, using placebo as a common comparator. Outcomes were evaluated at Weeks 12–16 and 24–28. A literature search identified 154 unique records including five studies that met eligibility criteria and were included in the analysis; two were tildrakizumab trials (reSURFACE 1 and reSURFACE 2) and three guselkumab trials (VOYAGE 1, VOYAGE 2, and Ohtsuki et al.). Analysis was based on the intent-to-treat (ITT) population and for all outcomes, the number of events reported were analysed as a proportion of the number of patients randomised to ensure consistency across trials. Outcomes assessed were: severity of psoriasis as defined by the Psoriasis Area and Severity Index (PASI) 75 and PASI 90, frequency of serious adverse events (SAEs), and treatment discontinuations.

RESULTS : There was no statistically significant difference between guselkumab and tildrakizumab for PASI 75, PASI 90, SAE and rate of discontinuations at either timepoint at Weeks 12–16 and Weeks 24–28.

CONCLUSIONS : This indirect comparison does not provide evidence that one treatment is superior to the other.