Efficacy and Safety of Tildrakizumab in Elderly Patients With Psoriasis: A Narrative Review.

BACKGROUND

Tildrakizumab is an anti-interleukin 23 p19 monoclonal antibody approved for the treatment of adults with moderate-to-severe plaque psoriasis. Globally, patients aged ≥65 years are 9.8% to 12.8% of patients with psoriasis who are treated with biologics, but they are often underrepresented in clinical trials.

OBJECTIVE

To summarize the available evidence on the efficacy and safety of tildrakizumab in patients aged ≥65 years with psoriasis for a United States (US)-based healthcare practitioners audience.

METHODS

A PubMed search was conducted using the search terms "(tildrakizumab OR MK-3222 OR Ilumya) AND psoriasis AND (elderly OR 65 years)" to identify English-language clinical trials and real-world studies evaluating efficacy and safety of tildrakizumab in elderly patients with psoriasis.

RESULTS

Two clinical trials and 5 real-world studies describing the efficacy and safety of tildrakizumab in patients aged ≥65 years were identified. The short- and long-term efficacy of tildrakizumab was comparable between patients aged <65 and ≥65 years. Adverse events were consistent with those observed among the overall clinical trial population, with some expected increases in age-related events.

LIMITATIONS: The number of studies with data for patients aged ≥65 years, and sample sizes within some studies, were small, limiting interpretation.

CONCLUSION

Based on available data, the established efficacy and safety profiles of tildrakizumab are maintained in patients aged ≥65 years with moderate-to-severe plaque psoriasis. Practical considerations, including insurance coverage, quarterly maintenance dosing, and in-office administration, in the US may increase treatment adherence and make tildrakizumab an appropriate treatment option for elderly patients.