Real-life experience of tildrakizumab 200 mg in complex psoriatic patients: a case series.

Background/Objectives: The management of moderate-to-severe plaque psoriasis may be particularly challenging in patients with a high disease burden and multiple comorbidities. This case series provides real-world evidence on the effectiveness of tildrakizumab 200 mg in patients with moderate-to-severe psoriasis characterized by clinical factors such as multiple comorbidities, high body weight, involvement of difficult-to-treat areas, and prior therapeutic failures. Methods: We present a series of six clinical cases describing baseline characteristics, treatment history and outcomes of patients with moderate-to-severe psoriasis treated with tildrakizumab 200 mg. Results: Although most of the patients included in this report showed multiple chronic or acute comorbidities (mainly cardiometabolic), high body weight, involvement of difficult-to-treat areas and failure to previous treatments (including biologics), tildrakizumab induced mostly complete remissions with most patients achieving PASI90 or PASI100 responses within 4-12 weeks; complete clearance (PASI100) was observed in four out of six patients. Treatment effectiveness was maintained over a follow-up of approximately 24 months in most cases, with a favorable safety profile. Conclusions: Tildrakizumab 200 mg demonstrated high effectiveness and sustained clinical responses in patients with moderate-to-severe psoriasis characterized by high disease burden and multiple comorbidities in a real-world setting.