Efficacy and safety of tildrakizumab in elderly patients: real-world multicenter study (ESTER – study)

Abstract

Purpose of the article: Interleukin-23 inhibitors, such as tildrakizumab, have emerged as safe and effective options for the management of psoriasis. Yet their efficacy in elderly patients (aged 65 years or more), particularly in those with difficult-to-treat areas involvement, remains insufficiently explored. We conducted this real-life retrospective multicentric observational study to assess the effectiveness of tildrakizumab in elderly patients with moderate-to-severe psoriasis, with involvement of difficult-to-treat areas.Materials and methods: We enrolled forty-nine patients aged 65 years old or more (mean age 73.1 ± 6.0), all treated with tildrakizumab for at least 28 weeks. The effectiveness of tildrakizumab was assessed by Static Physician’s Global Assessment of Genitalia (sPGA-G), fingernail-PGA (f-PGA), palmoplantar PGA (pp-PGA), scalp-specific PGA (sc-PGA), and Psoriasis Area and Severity Index (PASI) scores.Results: Significant improvements in PASI scores were observed within 28 weeks of treatment, with 77.5%, 60%, and 45.2% of patients achieving PASI75, PASI90, and PASI100, respectively. The mean PASI decreased significantly from baseline (13.6 ± 9.9) to 1.3 ± 1.7 at week 28. More than 90% of patients had clear sPGA-G and pp-PGA scores and over 70% had clear f-PGA and sc-PGA scores after 28 weeks.Conclusions: Our findings suggest that tildrakizumab could be a valuable option for the treatment of elderly patients, including those with difficult-to-treat areas involvement.

Keywords:

• Tildrakizumab
• immunomodulatory therapies
• biologics
• psoriasis
• psoriasis treatment
• anti-IL-23-biologics
• elderly patients
• difficult-to-treat areas

Acknowledgements

Editorial assistance was provided by Luca Giacomelli, PhD, Valeria Benedusi, PhD, Aashni Shah and Valentina Attanasio (Polistudium SRL, Milan, Italy). This assistance was supported by internal funds.

Ethics approval

Institutional review board approval was exempted as the study protocol did not deviate from standard clinical practice. All included patients provided written consent for retrospective study of data collected during routine clinical practice (demographics, clinical scores). The study was conducted in accordance with the Helsinki Declaration of 1964 and its later amendments. Data collection and handling complied with applicable laws, regulations, and guidance regarding patient protection, including patient privacy

Discloure statement

D. Orsini has been a speaker and/or consultant for Abbvie, LeoPharma, UCB, Bristol-Meyer-Squibb and Boehringer-Ingelheim. G Caldarola has received consulting fees, honoraria and support for attending meetings from Abbvie, Lilly, Almirall, Janssen, UCB, Novartis and Leopharma; A. Dattola has served as a speaker, consultant or advisory board member from Abbvie, Almirall, Amgen, Eli Lilly, Leo Pharma, Janssen, Novartis, Boehringer Ingelheim and UCB Pharma. C De Simone has received support for consulting fees, honoraria and support for attending meetings from Abbvie, Lilly, Janssen, UCB, Novartis, Leopharma, Sanofi and Almiral; L. Bianchi has received honoraria as a speaker or consultant for AbbVie, Janssen, Almirall Eli-Lilly, Leopharma, Novartis, Sanofi, Pfizer and UCB Pharma; K Peris has received support for consulting fees and honoraria from Abbvie, Almirall, Biogen, Celgene, Janssen Galderma, Novartis, Lilly, Novartis, Pierre Fabre, Sandoz, Sanofi and Sun Pharma.

Data availability statement

Additional data supporting the findings of this study are available from the Corresponding Author on reasonable request.

Additional information

Funding

Pusblishing charges are supported from Voucher by BIBLIOSAN.