New Findings on Tildrakizumab for Nail Psoriasis, with Paul Yamauchi, MD, PhD

New phase 3b findings presented at the American Academy of Dermatology (AAD) Annual Meeting demonstrated that tildrakizumab-asmn treatment led to significant improvements in moderate-to-severe nail psoriasis versus placebo, as well as a lack of new safety signals.

These data resulted from a study authored, in part, by Paul S. Yamauchi, MD, PhD, who works as a clinical assistant professor at the David Geffen School of Medicine at UCLA’s Division of Dermatology. Yamauchi spoke with HCPLive about his team’s findings on tildrakizumab and the study’s notable findings.

“So tildrakizumab was dosed at Week 0, Week 4, and every 12 weeks those patients on placebo were also given the placebo at Week 0, Week 4 and and Week 16,” Yamauchi said. “After Week 16, patients who were on tildrakizumab continued. Those patients on placebo were crossed over to receive tildrakizumab [at Week 28]. This was a 1-year study.”

Yamauchi highlighted several notable findings, including that participants demonstrated a significantly higher rate of 75% improvement from the point of baseline in their Nail Psoriasis Severity Index (mNAPSI 75) scores at the 28-week mark compared to those given a placebo. Specifically, it had been a 25.5% mNAPSI 75 response rate versus a 4.5% rate in the placebo arm (P = .003).

Additionally, he highlighted that 29.4% of those treated with tildrakizumab were shown to have attained normal nails or nails that had minimal levels of psoriasis (ViSENPsO score of 0 or 1), as opposed to the 4.2% rate observed among those given the placebo (P = .0008).

Lastly, Yamauchi highlighted that the drug’s safety profile had shown consistency with that of the known profile of tildrakizumab. He highlighted a lack of serious adverse events linked to the drug’s use in the trial.

“It demonstrates very good efficacy to treat psoriasis, as well as convenient dosing every 3 months, which will enhance compliance,” Yamauchi said. “The efficacy of this drug is very good for plaque psoriasis and has an excellent safety profile, in that infections were the only 1 of the events that we're seeing in the clinical trials for tildrakizumab has no warnings about cancers or serious infections.”

This was the first study of an interleukin (IL)-23 inhibitor to assess the efficacy of such a drug in those with nail psoriasis. Additionally, effective and long-term medications for treating those with nail psoriasis are known to have been limited.

For more information on tildrakizumab’s results among patients with nail psoriasis, view the full video posted above. To learn more about data presented at AAD, view our latest conference coverage.

The quotes contained in this interview were edited for clarity. Yamauchi has reported grants from Arcutis Biotherapeutics, Amgen, AbbVie, Lilly, Janssen, LEO Pharma, Pfizer, Regeneron, Sanofi, Dermavant, EPI Health, Novartis, Incyte, and Sun Pharma.