Plaque psoriasis (PsO) is an inflammatory skin disease that can impair quality of life. Tildrakizumab, an anti-IL-23 p19 monoclonal antibody, offers a treatment option for patients eligible for systemic therapy or phototherapy, but real-world results have not been comprehensively analyzed. This systematic review and meta-analysis evaluated real-world effectiveness, quality-of-life impact, and safety of tildrakizumab for treatment of moderate-to-severe plaque PsO, alone and relative to guselkumab and risankizumab. MEDLINE® and Embase were searched on November 16, 2023, along with meeting abstracts (2021–2023) and bibliographies of previous reviews, for English-language real-world studies of tildrakizumab (singly or comparative) in adults with chronic moderate-to-severe plaque PsO. Outcomes included effectiveness (Psoriasis Area and Severity Index [PASI], Physician’s Global Assessment [PGA], body surface area percentage [
As the treatment landscape for alopecia areata (AA) expands, it is crucial to understand how treatment properties impact clinician decision-making. The objective of the study was to understand how clinicians treating AA make decisions and evaluate the relative importance (RI) of treatment attributes. An online discrete choice experiment (DCE) was conducted among clinicians treating AA recruited through M3 Global Research’s US panel from February to March 2024. Treatment selection was evaluated using a series of 10 hypothetical binary choices. Preference weights from the DCE were estimated from conditional logistic regression models and were used to calculate willingness to trade off and attributes’ RI. For preference of prescription drug profile, clinicians chose among three blinded profiles of Janus kinase (JAK) inhibitor treatments approved for use in AA based on data from phase 2b–3 pivotal studies. Drug profile A was based on baricitinib 4-mg data, profile B on ritlecitinib 50-mg data, and profile C on deuruxolitinib 8-mg data. These blinded profiles were ranked as most and least preferred. Of the 249 screened clinicians, 155 were eligible for analysis (129 dermatologists, 15 physician assistants, and 11 nurse practitioners). Clinicians were predominantly White (75.5
ABSTRACT Biologics and Janus kinase (JAK) inhibitors have transformed the management of atopic dermatitis (AD), yet some patients experience early worsening of disease activity during treatment initiation. In clinical trials, these events are typically recorded as treatment‐emergent adverse events (TEAEs), most commonly coded as “atopic dermatitis”. We conducted a structured narrative review of phase 3 randomized trials evaluating approved systemic therapies for AD used in combination with background topical therapy. Trials of dupilumab, lebrikizumab, tralokinumab, nemolizumab, upadacitinib, and abrocitinib, including AD UP, JADE COMPARE, LIBERTY AD CHRONOS, ECZTRA 3, ARCADIA 1 and 2, and ADhere were included. Study design characteristics, background topical protocols, rescue therapy rules, dermatitis‐related TEAEs reported during the first 16 weeks of treatment were extracted from published data. Dermatitis TEAEs varied widely, ranging from 1% to 29% in treatment arms and 3% to over 41% in placebo groups. Substantial heterogeneity existed in baseline disease severity, topical therapy requirements, rescue allowances, and whether worsening was protocol‐defined or captured through investigator‐reported MedDRA coding. Because TEAEs labeled as atopic dermatitis may reflect natural disease variability, reporting conventions, or protocol factors rather than direct drug effects, cross‐trial comparisons should be interpreted cautiously. Clinicians are reminded to counsel patients that transient worsening may occur and emphasize the importance of adherence to adjunctive topical therapy. Standardized definitions of AD‐related adverse events are needed to improve interpretability across future trials.
