Real-World Effectiveness and Safety of Tildrakizumab in a Large Spanish Multicenter Cohort from Spanish Psoriasis Group (GPS)

Background: Tildrakizumab, an anti-IL-23p19 monoclonal antibody, has demonstrated efficacy in clinical trials, but real-world evidence remains crucial for confirming its profile in diverse populations. Methods: We have conducted a multicenter, retrospective observational study within the Spanish Psoriasis Group (GPS). This study updates previous findings with a larger sample size (n = 372) and longer follow-up. We assessed absolute Psoriasis Area and Severity Index (PASI), Body Surface Area (BSA), and the Dermatology Life Quality Index (DLQI) improvements, as well as safety, in patients with moderate-to-severe plaque psoriasis. Results: The cohort included a large population of patients with a high prevalence of comorbidities and prior biologic exposure. Effectiveness was high, with a significant proportion of patients achieving PASI < 1. Compared to recent real-world data, our cohort demonstrates superior complete clearance rates (PASI < 1) and includes a comprehensive DLQI assessment. Notably, 79 patients were aged ≥65 years, confirming the drug’s utility in the elderly. Safety was consistent with previous reports, with no new signals detected. Conclusions: Tildrakizumab shows robust effectiveness and safety in a complex, bio-experienced real-world population. The lack of clinical predictors of response suggests a need for future pharmacogenetic exploration.