The following article is part of coverage from the American Academy of Dermatology’s Annual Meeting (AAD 2020). Because of concerns regarding the coronavirus disease 2019 (COVID-19) pandemic, all AAD 2020 sessions and presentations were transitioned to a virtual format. While live events will not proceed as planned, readers can click here to view more news related to research presented during the AAD VMX 2020 virtual experience.
Tildrakizumab, a humanized monoclonal antibody approved for the treatment of moderate to severe plaque psoriasis, is effective for psoriasis treatment in patients with and without metabolic syndrome (MetS), according to the results of 2 post hoc analyses presented at the American Academy of Dermatology’s Virtual Meeting Experience (AAD VMX) 2020, held online from June 12 to 14, 2020.1,2
MetS has been associated with lower response to psoriasis treatment. Using data from 2 ongoing, phase 3, randomized controlled trials (reSURFACE 1 and 2; ClinicalTrials.gov Identifiers: NCT01722331 and NCT01729754), investigators sought to examine whether MetS status affected the efficacy of tildrakizumab in adults with up to 3 years of follow-up data.
In both trials, patients with moderate to severe chronic plaque psoriasis continuously received either 100 or 200 mg of tildrakizumab at baseline, 4 weeks, and every 12 weeks thereafter. In the reSURFACE 1 post hoc analysis, 124 patients received tildrakizumab 100 mg, of whom 21% had MetS at baseline. The rate of MetS was similar (23%) in the 147 patients from reSURFACE 1 who received tildrakizumab 200 mg. In the reSURFACE 2 analysis, 214 patients received tildrakizumab 100 mg and 160 received tildrakizumab 200 mg. Rates of baseline MetS in these groups were 21% and 19%, respectively.
In both analyses, the percentage of patients who achieved ≥75% Psoriasis Area and Severity Index (PASI 75) score improvement from baseline to 52 weeks was comparable regardless of MetS status. Comparing patients with vs without MetS, rates of PASI 75 achievement were 85% vs 86% with tildrakizumab 100 mg and 76% vs 76% with tildrakizumab 200 mg in patients from reSURFACE 1. In reSURFACE 2, the percentage of patients with vs without MetS who achieved PASI 75 at 52 weeks was 86% vs 94% with tildrakizumab 100 mg and 87% vs 87% with tildrakizumab 200 mg.
Comparable rates of PASI 75 achievement were also seen at weeks 100 and 148 between the groups with vs without metabolic syndrome in both post hoc analyses.
At week 148, overall PASI scores had decreased from baseline in a similar percentage of patients with vs without MetS in both studies: 89% vs 92% of patients who received tildrakizumab 100 mg in reSURFACE 1, 88% vs 91% of patients who received tildrakizumab 200 mg in reSURFACE 1, 93% vs 96% of patients who received tildrakizumab 100 mg in reSURFACE 2, and 84% vs 94% of patients who received tildrakizumab 200 mg in reSURFACE 2.
Taken together, the results of both post hoc analyses support maintained and comparable efficacy of tildrakizumab in patients with vs without MetS.
Disclosures: These studies were funded by Merck Sharp & Dohme Corp. Several study authors declared affiliations with the pharmaceutical industry. Please see the original references for a full list of authors’ disclosures.
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1. Pieper K, Mehta NN, Gottleib AB, et al. Tildrakizumab efficacy by metabolic syndrome status in psoriasis: post hoc analysis of 3-year data from phase 3 reSURFACE 1 study. Presented at: AAD VMX 2020; June 12-14, 2020. Abstract 15938.
2. Pieper K, Mehta NN, Lebwohl MG, et al. Tildrakizumab efficacy by metabolic syndrome status in psoriasis: post hoc analysis of 3-year data from phase 3 reSURFACE 2 study. Presented at: AAD VMX 2020; June 12-14, 2020. Abstract 15950.