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Novel selective IL-23 blocker equally effective in patients with metabolic syndrome

Presented by
Dr Alice Gottlieb, Tufts University School of Medicine, USA
EADV 2019
reSURFACE 1 and 2
Two post-hoc analyses of data from the reSURFACE 1 and 2 studies compared the efficacy of tildrakizumab in people with and without metabolic syndrome. Surprisingly, no difference was observed in efficacy between these groups [1,2].

Obesity and metabolic syndrome are common comorbidities in patients with moderate-to-severe psoriasis. The adipose tissue is a complex organ that secretes several adipokines, involved in the regulation of several metabolic processes. The unbalanced production of pro- and anti-inflammatory adipokines in obesity contributes to the development of a chronic low-grade inflammation state, which seems to favour worsening of psoriasis lesions and a poorer response to treatment [3]. Previous data has shown that obese patients often show a reduced response to therapy [4]. The metabolic syndrome can also have a negative impact on long-term drug survival of biologic treatment [5].

Tildrakizumab is a selective IL-23 blocker for therapy of chronic plaque psoriasis. Its efficacy and safety was assessed in the phase 3 trials reSURFACE 1 and reSURFACE 2. In a post-hoc analysis, efficacy was analysed in patients who had metabolic syndrome at baseline compared with patients without this comorbidity in both studies [1,2].

At 3 years, the proportion of patients who achieved PASI 75/90/100 was comparable between those with and without metabolic syndrome in both studies. In the reSURFACE 1 study, 69% of patients with metabolic syndrome compared with 71% without this comorbidity achieved a PASI 75 response [2]. The corresponding percentages for PASI 90 response were 42% versus 51% of patients without metabolic syndrome.

In addition, 3-year adverse event rates usually associated with metabolic syndrome were comparable in study participants with and without metabolic syndrome. These results show that tildrakizumab can help patients with moderate-to-severe plaque psoriasis, regardless of the presence of a metabolic syndrome achieve and maintain significant long-term skin clearance over.

    1. Gottlieb A, et al. P1650, EADV 2019, 9-13 Oct, Madrid, Spain.
    2. Lebwohl M, et al. P1653, EADV 2019, 9-13 Oct, Madrid, Spain.
    3. Coimbra S, et al. J Eur Acad Dermatol Venereol 2016;30:1876-85.
    4. Talamonti M, et al. J Eur Acad Dermatol Venereol 2018;32:1737-44.
    5. Jacobi A, et al. Int J Dermatol. 2016;55:296-302.

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