Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Science, University of La Sapienza, Rome, Italy.
Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy.
J Dermatolog Treat. 2024 Dec;35(1):2420825. doi: 10.1080/09546634.2024.2420825. Epub 2024 Oct 27.
Psoriasis is a chronic immune-mediated disease that can be challenging to treat, especially in patients with severe disease or high body weight. Tildrakizumab is a monoclonal antibody which inhibits IL-23, approved for moderate-to-severe psoriasis with a standard 100 mg dose. A 200 mg dose may provide greater efficacy for patients over 90 kg or with high disease burden. This multicenter, prospective study evaluated the effectiveness and safety of tildrakizumab 200 mg in patients with moderate-to-severe psoriasis, focusing on those with specific challenges: body weight over 90 kg, baseline PASI ≥20, and difficult-to-treat areas. The study also compared bio-naive versus bio-experienced and male versus female patients. Adults received tildrakizumab 200 mg subcutaneously at weeks 0 and 4, then every 12 weeks. Clinical improvements were assessed using PASI, DLQI, genital PASI, and NAPSI scores. After 24 weeks, the mean PASI score dropped from 14.6 to 0.4, with PASI 90 and PASI 100 scores exceeding 80% (100.0% and 80.3%, respectively). DLQI scores improved from 14.2 to 1.8, and significant improvements were seen in genital PASI and NAPSI scores. No significant adverse events occurred. Tildrakizumab 200 has been shown to be an effective therapeutic option, particularly for patients with high body weight, significant disease burden, and involvement of sensitive areas with no new safety signals.
银屑病是一种慢性免疫介导性疾病，治疗具有挑战性，尤其是对于重度疾病或高体重患者。替度鲁单抗是一种单克隆抗体，可抑制白细胞介素 23，适用于中重度银屑病，标准剂量为 100mg。对于体重超过 90kg 或疾病负担高的患者，200mg 剂量可能会提供更大的疗效。这项多中心、前瞻性研究评估了替度鲁单抗 200mg 治疗中重度银屑病患者的有效性和安全性，重点关注具有特定挑战的患者：体重超过 90kg、基线 PASI≥20 以及难以治疗的部位。该研究还比较了生物初治和生物经验丰富患者以及男性和女性患者。成年人在第 0 周和第 4 周接受替度鲁单抗 200mg 皮下注射，然后每 12 周注射一次。使用 PASI、DLQI、生殖器 PASI 和 NAPSI 评分评估临床改善情况。24 周后，平均 PASI 评分从 14.6 降至 0.4，PASI 90 和 PASI 100 评分超过 80%（分别为 100.0%和 80.3%）。DLQI 评分从 14.2 改善至 1.8，生殖器 PASI 和 NAPSI 评分也有显著改善。未发生严重不良事件。替度鲁单抗 200 已被证明是一种有效的治疗选择，特别是对于高体重、疾病负担重以及涉及敏感部位的患者，且无新的安全信号。
