Tildrakizumab improves high burden skin symptoms, impaired sleep and quality of life of moderate-to-severe plaque psoriasis patients in conditions close to clinical practice.


Journal

Journal of the European Academy of Dermatology and Venereology : JEADV
ISSN: 1468-3083
Titre abrégé: J Eur Acad Dermatol Venereol
Pays: England
ID NLM: 9216037

Informations de publication

Date de publication:
Oct 2023
Historique:
received: 13 12 2022
accepted: 20 04 2023
medline: 23 10 2023
pubmed: 29 5 2023
entrez: 29 5 2023
Statut: ppublish

Résumé

Tildrakizumab (TIL) is an interleukin (IL)-23p19 inhibitor for the treatment of moderate-to-severe plaque psoriasis with long-term efficacy and safety demonstrated in Phase III trials. Studies conducted in conditions closer to clinical practice are needed. The TRIBUTE study (open-label, Phase IV) assessed the efficacy and impact on health-related quality of life (HRQoL) of TIL 100 mg in adult moderate-to-severe psoriasis patients (naïve to IL-23/Th17 pathway inhibitors) in conditions similar to clinical practice. Key efficacy measure was Psoriasis Area Severity Index (PASI). HRQoL was evaluated using the Dermatology Life Quality Index (DLQI) and Skindex-16. Additional patient-reported outcomes included Pain-, Pruritus- and Scaling-Numerical Rating Scale (NRS), Medical Outcome Study (MOS)-Sleep, Work Productivity and Activity Impairment (WPAI), Patient Benefit Index (PBI) and Treatment Satisfaction Questionnaire for Medication (TSQM). One hundred and seventy-seven patients were enrolled (six patients did not complete the study). After 24 weeks, the proportion of patients achieving PASI scores ≤ 3, PASI 75, PASI 90 and DLQI 0/1 was 88.4%, 92.5%, 74.0% and 70.4%, respectively. Skindex-16 overall score improved (mean absolute change from baseline, MACB [95%CI]: -53.3 [-58.1, -48.5]). Significant benefits (MACB [95%CI]) were found on pruritus-, pain- and scaling-NRS scores (-5.7 [-6.1, -5.2], -3.5 [-4.1, -3.0] and -5.7 [-6.2, -5.2], respectively), MOS-Sleep (-10.4 [-13.3, -7.4] Sleep problems Index II) and WPAI (-36.4 [-42.6, -30.2] activity impairment, -28.2 [-34.7, -21.7] productivity loss, -27.0 [-32.9, -21.1] presenteeism and -6.8 [-12.1, -1.5] absenteeism). 82.7% of patients reported PBI ≥ 3 and the mean (SD) global TSQM score was high (80.5 [18.5]). Only one serious treatment-emergent adverse event was reported (not-related to TIL). TIL 100 mg treatment after 24 weeks in conditions close to real clinical practice showed a quick and high improvement in psoriasis signs and HRQoL. Patient reported improvements in sleep outcomes and work productivity, relevant benefits and high treatment satisfaction. The safety profile was favourable and consistent with Phase III trials.

Sections du résumé

BACKGROUND BACKGROUND
Tildrakizumab (TIL) is an interleukin (IL)-23p19 inhibitor for the treatment of moderate-to-severe plaque psoriasis with long-term efficacy and safety demonstrated in Phase III trials. Studies conducted in conditions closer to clinical practice are needed.
OBJECTIVES OBJECTIVE
The TRIBUTE study (open-label, Phase IV) assessed the efficacy and impact on health-related quality of life (HRQoL) of TIL 100 mg in adult moderate-to-severe psoriasis patients (naïve to IL-23/Th17 pathway inhibitors) in conditions similar to clinical practice.
METHODS METHODS
Key efficacy measure was Psoriasis Area Severity Index (PASI). HRQoL was evaluated using the Dermatology Life Quality Index (DLQI) and Skindex-16. Additional patient-reported outcomes included Pain-, Pruritus- and Scaling-Numerical Rating Scale (NRS), Medical Outcome Study (MOS)-Sleep, Work Productivity and Activity Impairment (WPAI), Patient Benefit Index (PBI) and Treatment Satisfaction Questionnaire for Medication (TSQM).
RESULTS RESULTS
One hundred and seventy-seven patients were enrolled (six patients did not complete the study). After 24 weeks, the proportion of patients achieving PASI scores ≤ 3, PASI 75, PASI 90 and DLQI 0/1 was 88.4%, 92.5%, 74.0% and 70.4%, respectively. Skindex-16 overall score improved (mean absolute change from baseline, MACB [95%CI]: -53.3 [-58.1, -48.5]). Significant benefits (MACB [95%CI]) were found on pruritus-, pain- and scaling-NRS scores (-5.7 [-6.1, -5.2], -3.5 [-4.1, -3.0] and -5.7 [-6.2, -5.2], respectively), MOS-Sleep (-10.4 [-13.3, -7.4] Sleep problems Index II) and WPAI (-36.4 [-42.6, -30.2] activity impairment, -28.2 [-34.7, -21.7] productivity loss, -27.0 [-32.9, -21.1] presenteeism and -6.8 [-12.1, -1.5] absenteeism). 82.7% of patients reported PBI ≥ 3 and the mean (SD) global TSQM score was high (80.5 [18.5]). Only one serious treatment-emergent adverse event was reported (not-related to TIL).
CONCLUSIONS CONCLUSIONS
TIL 100 mg treatment after 24 weeks in conditions close to real clinical practice showed a quick and high improvement in psoriasis signs and HRQoL. Patient reported improvements in sleep outcomes and work productivity, relevant benefits and high treatment satisfaction. The safety profile was favourable and consistent with Phase III trials.

Identifiants

pubmed: 37246505
doi: 10.1111/jdv.19229
doi:

Substances chimiques

tildrakizumab DEW6X41BEK
Antibodies, Monoclonal 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2004-2015

Subventions

Organisme : Almirall R&D

Informations de copyright

© 2023 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.

Références

Boehncke WH, Schön MP. Psoriasis. Lancet. 2015;386(9997):983-94.
Parisi R, Symmons DP, Griffiths CE, Ashcroft DM. Global epidemiology of psoriasis: a systematic review of incidence and prevalence. J Invest Dermatol. 2013;133(2):377-85.
Ghoreschi K, Balato A, Enerbäck C, Sabat R. Therapeutics targeting the IL-23 and IL-17 pathway in psoriasis. Lancet. 2021;397(10275):754-66.
European medicines agency. Ilumetri [Internet]. 2018 [cited 2021 Dec 16]. Available from: https://www.ema.europa.eu/en/medicines/human/EPAR/ilumetri
Reich K, Papp KA, Blauvelt A, Tyring SK, Sinclair R, Thaçi D, et al. Tildrakizumab versus placebo or etanercept for chronic plaque psoriasis (reSURFACE 1 and reSURFACE 2): results from two randomised controlled, phase 3 trials. Lancet. 2017;390(10091):276-88.
Thaci D, Piaserico S, Warren R b, Gupta A k, Cantrell W, Draelos Z, et al. Five-year efficacy and safety of tildrakizumab in patients with moderate-to-severe psoriasis who respond at week 28: pooled analyses of two randomized phase III clinical trials (reSURFACE 1 and reSURFACE 2). Br J Dermatol. 2021;185(2):323-34.
Mason KJ, Barker JNWN, Smith CH, Hampton PJ, Lunt M, McElhone K, et al. Comparison of drug discontinuation, effectiveness, and safety between clinical trial eligible and ineligible patients in BADBIR. JAMA Dermatol. 2018;154(5):581-8.
Masson Regnault M, Castañeda-Sanabria J, Diep Tran MHT, Beylot-Barry M, Bachelez H, Beneton N, et al. Users of biologics in clinical practice: would they be eligible for phase III clinical studies? Cohort study in the French psoriasis registry PSOBIOTEQ. J Eur Acad Dermatol Venereol. 2020;34(2):293-300.
Drerup KA, Seemann C, Gerdes S, Mrowietz U. Effective and safe treatment of psoriatic disease with the anti-IL-23p19 biologic Tildrakizumab: results of a real-world prospective cohort study in nonselected patients. Dermatology. 2022;238(4):615-9.
Ljosaa TM, Mork C, Stubhaug A, Moum T, Wahl AK. Skin pain and skin discomfort is associated with quality of life in patients with psoriasis. J Eur Acad Dermatol Venereol. 2012;26(1):29-35.
Strober BE, Sobell JM, Duffin KC, Bao Y, Guérin A, Yang H, et al. Sleep quality and other patient-reported outcomes improve after patients with psoriasis with suboptimal response to other systemic therapies are switched to adalimumab: results from PROGRESS, an open-label phase IIIB trial. Br J Dermatol. 2012;167(6):1374-81.
Kimball AB, Edson-Heredia E, Zhu B, Guo J, Maeda-Chubachi T, Shen W, et al. Understanding the relationship between pruritus severity and work productivity in patients with moderate-to-severe psoriasis: sleep problems are a mediating factor. J Drugs Dermatol. 2016;15(2):183-8.
Prignano F, Ricceri F, Pescitelli L, Lotti T. Itch in psoriasis: epidemiology, clinical aspects and treatment options. Clin Cosmet Investig Dermatol. 2009;2:9-13.
Tyring S, Gottlieb A, Papp K, Gordon K, Leonardi C, Wang A, et al. Etanercept and clinical outcomes, fatigue, and depression in psoriasis: double-blind placebo-controlled randomised phase III trial. Lancet. 2006;367(9504):29-35.
Zhu B, Edson-Heredia E, Guo J, Maeda-Chubachi T, Shen W, Kimball AB. Itching is a significant problem and a mediator between disease severity and quality of life for patients with psoriasis: results from a randomized controlled trial. Br J Dermatol. 2014;171(5):1215-9.
Taliercio VL, Snyder AM, Webber LB, Langner AU, Rich BE, Beshay AP, et al. The disruptiveness of itchiness from psoriasis: a qualitative study of the impact of a single symptom on quality of life. J Clin Aesthet Dermatol. 2021;14(6):42-8.
Llamas-Velasco M, de la Cueva P, Notario J, Martínez-Pilar L, Martorell A, Moreno-Ramírez D. Moderate psoriasis: a proposed definition. Actas Dermosifiliogr. 2017;108(10):911-7.
Gisondi P, Altomare G, Ayala F, Bardazzi F, Bianchi L, Chiricozzi A, et al. Italian guidelines on the systemic treatments of moderate-to-severe plaque psoriasis. J Eur Acad Dermatol Venereol. 2017;31(5):774-90.
Langley RG, Ellis CN. Evaluating psoriasis with psoriasis area and severity index, psoriasis global assessment, and lattice system Physician's global assessment. J Am Acad Dermatol. 2004;51(4):563-9.
Basra MKA, Fenech R, Gatt RM, Salek MS, Finlay AY. The dermatology life quality index 1994-2007: a comprehensive review of validation data and clinical results. Br J Dermatol. 2008;159(5):997-1035.
Rencz F, Gulácsi L, Péntek M, Szegedi A, Remenyik É, Bata-Csörgő Z, et al. DLQI-R scoring improves the discriminatory power of the dermatology life quality index in patients with psoriasis, pemphigus and morphea. Br J Dermatol. 2020;182(5):1167-75.
Reich A, Chatzigeorkidis E, Zeidler C, Osada N, Furue M, Takamori K, et al. Tailoring the cut-off values of the visual analogue scale and numeric rating scale in itch assessment. Acta Derm Venereol. 2017;97(6):759-60.
Chren MM. The Skindex instruments to measure the effects of skin disease on quality of life. Dermatol Clin. 2012;30(2):231-6.
Mrowietz U, Chouela EN, Mallbris L, Stefanidis D, Marino V, Pedersen R, et al. Pruritus and quality of life in moderate-to-severe plaque psoriasis: post hoc explorative analysis from the PRISTINE study. J Eur Acad Dermatol Venereol. 2015;29(6):1114-20.
Hays RD, Martin SA, Sesti AM, Spritzer KL. Psychometric properties of the medical outcomes study sleep measure. Sleep Med. 2005;6(1):41-4.
Rejas J, Ribera MV, Ruiz M, Masrramón X. Psychometric properties of the MOS (medical outcomes study) sleep scale in patients with neuropathic pain. Eur J Pain. 2007;11(3):329-40.
Wu JJ, Lin C, Sun L, Goldblum O, Zbrozek A, Burge R, et al. Minimal clinically important difference (MCID) for work productivity and activity impairment (WPAI) questionnaire in psoriasis patients. J Eur Acad Dermatol Venereol. 2019;33(2):318-24.
Feuerhahn J, Blome C, Radtke M, Augustin M. Validation of the patient benefit index for the assessment of patient-relevant benefit in the treatment of psoriasis. Arch Dermatol Res. 2012;304(6):433-41.
Augustin M, Kleyn CE, Conrad C, Sator PG, Ståhle M, Eyerich K, et al. Characteristics and outcomes of patients treated with apremilast in the real world: results from the APPRECIATE study. J Eur Acad Dermatol Venereol. 2021;35(1):123-34.
Gisondi P, Talamonti M, Chiricozzi A, Piaserico S, Amerio P, Balato A, et al. Treat-to-target approach for the Management of Patients with moderate-to-severe plaque psoriasis: consensus recommendations. Dermatol Ther (Heidelb). 2021;11(1):235-52.
Rencz F, Poór A, Péntek M, Holló P, Kárpáti S, Gulácsi L, et al. A detailed analysis of ‘not relevant’ responses on the DLQI in psoriasis: potential biases in treatment decisions. J Eur Acad Dermatol Venereol. 2018;32(5):783-90.
Langenbruch A, Radtke MA, Gutknecht M, Augustin M. Does the dermatology life quality index (DLQI) underestimate the disease-specific burden of psoriasis patients? J Eur Acad Dermatol Venereol. 2019;33(1):123-7.
Gordon KB, Reich K, Crowley JJ, Korman NJ, Murphy FT, Poulin Y, et al. Disease activity and treatment efficacy using patient-level psoriasis area and severity index scores from tildrakizumab phase 3 clinical trials. J Dermatolog Treat. 2022;33(1):219-28.
Caldarola G, Zangrilli A, Bernardini N, Bavetta M, De Simone C, Graceffa D, et al. Risankizumab for the treatment of moderate-to-severe psoriasis: a multicenter, retrospective, 1 year real-life study. Dermatol Ther. 2022;35(6):e15489.
Megna M, Tommasino N, Potestio L, Battista T, Ruggiero A, Noto M, et al. Real-world practice indirect comparison between guselkumab, risankizumab, and tildrakizumab: results from an Italian 28-week retrospective study. J Dermatolog Treat. 2022;33(6):2813-20.
Burlando M, Castelli R, Cozzani E, Parodi A. Treatment of moderate-to-severe plaque psoriasis with tildrakizumab in the real-life setting. Drugs Context. 2021;10:1-4.
Galluzzo M, Tofani L, Lombardo P, Petruzzellis A, Silvaggio D, Egan CG, et al. Use of Guselkumab for the treatment of moderate-to-severe plaque psoriasis: a 1 year real-life study. J Clin Med. 2020;9(7):2170.
Malara G, Trifirò C, Bartolotta A, Giofré C, D'Arrigo G, Testa A, et al. Real-world effectiveness and safety of Guselkumab for the treatment of psoriasis: a 6-month prospective study in a series of psoriatic patients. Eur Rev Med Pharmacol Sci. 2021;25(1):406-12.
Gerdes S, Asadullah K, Hoffmann M, Korge B, Mortazawi D, Wegner S, et al. Real-world evidence from the non-interventional, prospective, German multicentre PERSIST study of patients with psoriasis after 1 year of treatment with guselkumab. J Eur Acad Dermatol Venereol. 2022;36(9):1568-77.
Gkalpakiotis S, Cetkovska P, Arenberger P, Dolezal T, Arenbergerova M, Velackova B, et al. Risankizumab for the treatment of moderate-to-severe psoriasis: real-life multicenter experience from The Czech Republic. Dermatol Ther (Heidelb). 2021;11(4):1345-55.
Gerdes S, Bräu B, Hoffmann M, Korge B, Mortazawi D, Wiemers F, et al. Real-world effectiveness of guselkumab in patients with psoriasis: health-related quality of life and efficacy data from the noninterventional, prospective, German Multicenter PERSIST Trial. J Dermatol. 2021;48(12):1854-62.
del Alcázar E, López-Ferrer A, Martínez-Doménech Á, Ruiz-Villaverde R, del Llamas-Velasco M, Rocamora V, et al. Effectiveness and safety of guselkumab for the treatment of psoriasis in real-world settings at 24 weeks: a retrospective, observational, multicentre study by the Spanish psoriasis group. Dermatol Ther. 2022;35(2):e15231.
Ruggiero A, Picone V, Martora F, Fabbrocini G, Megna M. Guselkumab, risankizumab, and tildrakizumab in the management of psoriasis: a review of the real-world evidence. Clin Cosmet Investig Dermatol. 2022;15:1649-58.
Paudyal P, Apfelbacher C, Jones C, Siddiqui S, El-Turki A, DeGiovanni C, et al. ‘DLQI seems to be “action”, and Skindex-29 seems to be “emotion”’: qualitative study of the perceptions of patients with psoriasis or eczema on two common dermatology-specific quality of life measures. Acta Derm Venereol. 2020;100(8):adv00105, adv00106.
Szabó Á, Brodszky V, Rencz F. A comparative study on the measurement properties of dermatology life quality index (DLQI), DLQI-relevant and Skindex-16. Br J Dermatol. 2022;186(3):485-95.
Zachariae R, Lei U, Haedersdal M, Zachariae C. Itch severity and quality of life in patients with pruritus: preliminary validity of a Danish adaptation of the itch severity scale. Acta Derm Venereol. 2012;92(5):508-14.
Globe D, Bayliss MS, Harrison DJ. The impact of itch symptoms in psoriasis: results from physician interviews and patient focus groups. Health Qual Life Outcomes. 2009;7:62.
Elewski B, Alexis AF, Lebwohl M, Stein Gold L, Pariser D, Del Rosso J, et al. Itch: an under-recognized problem in psoriasis. J Eur Acad Dermatol Venereol. 2019;33(8):1465-76.
Pärna E, Aluoja A, Kingo K. Quality of life and emotional state in chronic skin disease. Acta Derm Venereol. 2015;95(3):312-6.
Gowda S, Goldblum OM, McCall WV, Feldman SR. Factors affecting sleep quality in patients with psoriasis. J Am Acad Dermatol. 2010;63(1):114-23.
Nowowiejska J, Baran A, Flisiak I. Mutual relationship between sleep disorders, quality of life and psychosocial aspects in patients with psoriasis. Front Psych. 2021;12:674460.
Jensen P, Zachariae C, Skov L, Zachariae R. Sleep disturbance in psoriasis: a case-controlled study. Br J Dermatol. 2018;179(6):1376-84.
Halioua B, Misery L, Seite S, Delvigne V, Chelli C, Taieb J, et al. Influence of skin subjective symptoms on sleep quality in patients with cutaneous disorders: a study of 2871 subjects. Clin Cosmet Investig Dermatol. 2021;14:143-52.
Gupta MA, Simpson FC, Gupta AK. Psoriasis and sleep disorders: a systematic review. Sleep Med Rev. 2016;29:63-75.
Nowowiejska J, Baran A, Lewoc M, Grabowska P, Kaminski TW, Flisiak I. The assessment of risk and predictors of sleep disorders in patients with psoriasis-a questionnaire-based cross-sectional analysis. J Clin Med. 2021;10(4):664.
Thaçi D, Galimberti R, Amaya-Guerra M, Rosenbach T, Robertson D, Pedersen R, et al. Improvement in aspects of sleep with etanercept and optional adjunctive topical therapy in patients with moderate-to-severe psoriasis: results from the PRISTINE trial. J Eur Acad Dermatol Venereol. 2014;28(7):900-6.
Kimball AB, Naegeli AN, Edson-Heredia E, Lin CY, Gaich C, Nikaï E, et al. Psychometric properties of the itch numeric rating scale in patients with moderate-to-severe plaque psoriasis. Br J Dermatol. 2016;175(1):157-62.
Schaefer CP, Cappelleri JC, Cheng R, Cole JC, Guenthner S, Fowler J, et al. Health care resource use, productivity, and costs among patients with moderate to severe plaque psoriasis in the United States. J Am Acad Dermatol. 2015;73(4):585-93.e3.
Finlay AY, Coles EC. The effect of severe psoriasis on the quality of life of 369 patients. Br J Dermatol. 1995;132(2):236-44.
Horn EJ, Fox KM, Patel V, Chiou CF, Dann F, Lebwohl M. Association of patient-reported psoriasis severity with income and employment. J Am Acad Dermatol. 2007;57(6):963-71.
Del Alcázar VE, Lamas Doménech N, Salleras RM. Absolute versus relative psoriasis area and severity index in clinical practice. Actas Dermosifiliogr (Engl Ed). 2019;110(7):606-10.
Carrascosa JM, Puig L, Romero IB, Salgado-Boquete L, Del Alcázar E, Lencina JJA, et al. Practical update of the guidelines published by the psoriasis Group of the Spanish Academy of dermatology and venereology (GPs) on the treatment of psoriasis with biologic agents: part 2 - Management of Special Populations, patients with comorbid conditions, and risk. Actas Dermosifiliogr. 2022;113(6):583-609.

Auteurs

Antonio Costanzo (A)

Section of Dermatology, Department of Biomedical Sciences, Humanitas University, Milan, Italy.
Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.

Mar Llamas-Velasco (M)

Department of Dermatology, Hospital Universitario de la Princesa, Madrid, Spain.

Gabriella Fabbrocini (G)

Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.

Aldo Cuccia (A)

Unit of Dermatology, San Donato Hospital, Arezzo, Italy.

Raquel Rivera-Diaz (R)

Department of Dermatology, Hospital Universitario 12 de Octubre, Universidad Complutense, Madrid, Spain.

Kristian Gaarn Du Jardin (K)

Almirall R&D, Barcelona, Spain.

Ismail Kasujee (I)

Almirall R&D, Barcelona, Spain.

Lluís Puig (L)

Department of Dermatology, IIB SANTPAU, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

José Manuel Carrascosa (JM)

Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH