Real-world patients with psoriasis demonstrated significant improvement in difficult-to-treat scalp, nail, palmoplantar, and genital disease manifestations with the IL-23 inhibitor tildrakizumab.
Tildrakizumab was associated with significant improvement in difficult-to-treat areas of psoriasis among real-world patients, according to study findings published recently in the Journal of Clinical Medicine.
Associated with a considerable impact on patient psychological well-being and quality of life, psoriasis morbidity is further exacerbated when located in sensitive and difficult-to-treat areas, such as the face, scalp, palms and soles (palmoplantar), nails, and genital region.
“Since patients with psoriasis in difficult-to-treat locations often receive inadequate treatment, the burden of the disease is often worse than patients not affected by these types of lesions. In general, topical treatments are not usually effective necessitating alternative treatment strategies,” explained the study authors.
Substantial improvements in the management of moderate to severe psoriasis with biological therapies have also demonstrated effectiveness in some difficult-to-treat areas, but data remain limited.
“Although there is accumulating evidence of the effectiveness of tildrakizumab in randomized controlled trials and more recently in real-life studies, little evidence is currently available on the use of this biologic in patients burdened with psoriasis in difficult-to-treat areas,” they added.
Researchers conducted a 28-week retrospective cohort analysis of patients with moderate to severe psoriasis treated with tildrakizumab (Ilumya), a monoclonal antibody targeting the p19 subunit of interleukin (IL)-23, at the Dermatology Unit, “Tor Vergata” University of Rome, Italy.
A total of 18 patients (mean [SD] age, 49.1 [12.7] years; mean [SD] disease duration, 14.3 [11.9] years; 61.1% male) with psoriasis localized in the genital region (n = 7), scalp (n = 6), nails (n = 5), and palmoplantar areas (n = 7) were assessed at weeks 0, 4, 12, and 28.
Safety and efficacy outcomes evaluated at each time point included the psoriasis area severity index (PASI), static Physician’s Global Assessment of Genitalia (sPGA-G), Psoriasis Scalp Severity Index (PSSI), Nail Area Psoriasis Severity Index (NAPSI), and the Palmoplantar Psoriasis Area and Severity Index (ppPASI).
Findings showed significant decreases in PASI of 73% and 79.1% at weeks 12 and 28, respectively, compared with baseline (mean PASI, 3.1 and 2.4 vs 11.5). Further improvements were observed with tildrakizumab in difficult-to-treat areas:
Researchers concluded that further long-term studies with a greater sample size are warranted to verify these preliminary findings.
Reference
Galluzzo M, Talamonti M, Cioni A, et al. Efficacy of tildrakizumab for the treatment of difficult-to-treat areas: scalp, nail, palmoplantar and genital psoriasis. J Clin Med. 2022;11(9):2631. doi:10.3390/jcm11092631
Navigating Health Literacy, Social Determinants, and Discrimination in National Health Plans
February 13th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the February 2024 issue of The American Journal of Managed Care® about their findings on how health plans can screen for health literacy, social determinants of health, and perceived health care discrimination.
Listen
Collecting SDOH Data Can Assess Risk of Medical Nonadherence, Improve HEI and Star Ratings
April 18th 2024At the Academy of Managed Care Pharmacy (AMCP) 2024 annual meeting, a panel of presenters explored changes coming to Medicare that incorporate social determinants of health (SDOH) data to improve patient and health system outcomes.
Read More
Drs Raymond Thertulien, Joseph Mikhael on Racial Disparities in Multiple Myeloma Care Access
December 28th 2023In the wake of the 2023 American Society of Hematology Annual Meeting and Exposition, Raymond Thertulien, MD, PhD, of Novant Health, and Joseph Mikhael, MD, MEd, FRCPC, FACP, chief medical officer of the International Myeloma Foundation, discussed health equity research highlights from the meeting and drivers of racial disparities in multiple myeloma outcomes.
Listen
Prices for care at hospital trauma centers vary across hospitals; drug shortages reached a record high during the first quarter of 2024; although 3 of the biggest makers of asthma inhalers pledged to cap out-of-pocket costs for some US patients at $35, these do not apply to daily inhalers used by the youngest kids with asthma.
Read More
Commonwealth Fund Report Details Pervasive Racial and Ethnic Disparities in US Health Care, Outcomes
April 18th 2024Using 25 health system performance indicators, the Commonwealth Fund 2024 State Health Disparities Report evaluated racial and ethnic disparities in health care and health outcomes both within and across US states and highlighted the urgent need for equitable health care policies and practices in the US.
Read More