Santos-Juanes Galache Raquel, Reyes García Sebastian, Carrero Martín Jimena, Nuñez Domínguez Álvaro, López Pando Marta, Álvarez Losada Irene, de la Fuente Villaverde Irene, Lozano-Blazquez Ana, Salgueiro Esther, Bordallo Javier, Santos-Juanes Jorge, Galache Osuna Cristina
Unidad de Gestion Clínica de Dermatología, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain.
Reumatology Department, Hospital Universitario de Santiago, 15706 Santiago de Compostela, Spain.
Life (Basel). 2025 May 15;15(5):789. doi: 10.3390/life15050789.
In routine clinical settings, identifying the factors that influence the persistence of biologic therapies is crucial for tailoring psoriasis management to individual patient profiles. This study aimed to evaluate the real-world drug survival of tildrakizumab in patients diagnosed with plaque psoriasis at the Dermatology Department of HUCA and to explore the clinical predictors of treatment discontinuation. We conducted a retrospective, hospital-based analysis involving 100 patients treated with tildrakizumab (Ilumetri) between 1 January 2021 and 30 April 2024. Kaplan-Meier estimates were used to construct survival curves, and multivariate analyses were performed using Cox proportional hazards regression models. Both crude and adjusted hazard ratios (HRs) were calculated to assess potential differences across patient subgroups. The multivariate analysis identified statistically significant associations between reduced drug survival and the presence of psoriatic arthritis ( = 0.02), previous biologic exposure ( = 0.02), and arterial hypertension ( = 0.012). Other comorbidities did not demonstrate significant effects. The most common reasons for treatment discontinuation were primary inefficacy and suboptimal response in patients with arthritis. Overall, tildrakizumab demonstrated robust survival outcomes in this patient population, though diminished persistence was observed in those with prior biologic use, comorbid arthritis, and hypertension.
在常规临床环境中，识别影响生物疗法持续使用的因素对于根据个体患者情况定制银屑病治疗方案至关重要。本研究旨在评估在HUCA皮肤科被诊断为斑块状银屑病的患者中替拉珠单抗的实际药物留存率，并探索治疗中断的临床预测因素。我们进行了一项基于医院的回顾性分析，纳入了2021年1月1日至2024年4月30日期间接受替拉珠单抗（Ilumetri）治疗的100例患者。采用Kaplan-Meier估计法构建生存曲线，并使用Cox比例风险回归模型进行多变量分析。计算了粗风险比和调整后风险比以评估不同患者亚组之间的潜在差异。多变量分析确定了药物留存率降低与银屑病关节炎的存在（P = 0.02）、既往生物制剂暴露（P = 0.02）和动脉高血压（P = 0.012）之间存在统计学显著关联。其他合并症未显示出显著影响。治疗中断的最常见原因是原发性无效和关节炎患者的反应欠佳。总体而言，替拉珠单抗在该患者群体中显示出良好的生存结果，尽管在既往使用过生物制剂、合并关节炎和高血压的患者中观察到留存率有所降低。
