Tildrakizumab Significantly Improves Work Productivity in Moderate to Severe Plaque Psoriasis

Neal Bhatia, MD

Credit: LiVDerm

In a real-world clinical setting, patients with moderate to severe plaque psoriasis receiving tildrakizumab treatment had significantly improved work productivity and decreased work activity impairment, according to data presented at the 2023 Fall Clinical Dermatology Conference.¹

“Psoriasis is a chronic, inflammatory skin disorder that negatively impacts patients’ physical health, quality of life, and work productivity, posing a substantial economic burden on the healthcare system and patients,” wrote Neal Bhatia, MD, director of clinical dermatology at Therapeutics Clinical Research and chief medical editor for Practical Dermatology, and colleagues.

The drug, an anti-interleukin-23 p19 monoclonal antibody, has been approved for the treatment of moderate to severe plaque psoriasis in adults. While previous research has demonstrated the efficacy of treatment with tildrakizumab, work productivity and reductions in activity impairment have not been assessed.

The phase 4, multicenter, uncontrolled, open-label, real-world study evaluated improvements in these factors for up to 64 weeks of tildrakizumab treatment in this patient population. The primary endpoint was the change from baseline in the Psychological General Well-Being Index (PGWBI) total score at the 28- and 52-week marks, and the secondary endpoint was change from baseline over time in activity impairment and work productivity, assessed at weeks 16, 28, 40, 52, and 64.

Work productivity was determined using the self-reported Work Productivity and Activity Impairment Questionnaire: Psoriasis (WPAI:PSO), which evaluates daily psoriasis-related activity impairment, time missed from work due to their condition (absenteeism), and the percentage reduction of productivity at work (presenteeism). Investigators also included total activity and work productivity impairments. Differences between baseline and posttreatment values were assessed using paired Student’s t-tests.

Eligible patients were aged ≥18 years, had moderate to severe plaque psoriasis, were candidates for phototherapy or systemic therapy, and had no active or untreated latent tuberculosis. Patients received tildrakizumab 100 mg at baseline and weeks 4, 15, 28, 40, and 52.

Of the 55 patients initially enrolled in the trial, 31 completed all WPAI:PSO domains at week 64. Most (94.5%) of patients were White, 50.9% were male, and the mean age was 48.6 years. At baseline, the mean body surface area (BSA) was 14.5 and the mean Psoriasis Area and Severity Index (PASI) was 11.6.

Except for absenteeism, statistically significant improvements in work productivity were observed beginning at week 16 for all WPAI:PSO domains. The mean presenteeism significantly decreased from baseline to week 64 in patients receiving tildrakizumab (20.5 vs 2.6, respectively; P <.001), with a change from baseline of -89.7%. Additionally, the mean total activity impairment domain score decreased significantly from baseline to week 64 (29.5 vs 4.4, respectively; P <.001), with a change in baseline of -87.0%.

The work productivity impairment domain scores were significantly decreased from baseline to the end of the study period (20.9 vs 2.6, respectively; P <.001) and the mean absenteeism domain score decreased from 1.1 at baseline to 0.0 at week 64, although this change was not statistically significant. Investigators noted this was likely due to the small baseline value for this domain.

References

1. ^{Bhatia N, Heim J, Schenkel B, Gogineni R, et al. Psoriasis-related work productivity improvement from a Phase 4 real-world study of tildrakizumab in patients with moderate-to-severe plaque psoriasis. Presented at: Fall Clinical Dermatology 2023 Conference. Las Vegas, NV. October 19 – 22, 2023.}