Tildrakizumab Improves Burdensome Symptoms and Psychological Well-Being Beyond Skin Clearance in Psoriasis
Results from the 2-year POSITIVE study demonstrate that tildrakizumab provides sustained improvements in both physical symptoms and psychological well-being in patients with moderate-to-severe plaque psoriasis, extending benefits beyond skin clearance.
The POSITIVE study is a 2-year, non-interventional study including 785 adults treated with tildrakizumab 100 or 200 mg. Outcomes included itch, pain, joint pain, and fatigue assessed via numeric rating scales (NRS), as well as psychological well-being measured by the World Health Organization-5 (WHO-5) index.
Patients experienced rapid and sustained symptom improvements. Mean itch scores decreased from 5.5 at baseline to 2.4 at week 16 and 1.5 at year 2 (P<0.0001). Similar improvements were observed for pain (3.8 to 1.5 to 0.8), joint pain (2.3 to 1.6 to 1.1), and fatigue (3.7 to 2.1 to 1.4).
Clinically meaningful responses were common. At week 16 and year 2, up to 79.3% to 81.1% of patients achieved ≥4-point reductions in itch and pain scores, with sustained improvements across all symptom domains.
Psychological well-being also improved significantly. WHO-5 scores increased from 53.7 at baseline to 63.2 at week 16—approaching general population levels—and further improved to 70.4 by year 2 (P<0.0001).
“Patients treated with tildrakizumab in a real-world setting achieved significant reductions in burdensome symptoms of psoriasis after 16 weeks, which were maintained over 2 years,” the authors concluded. “Tildrakizumab significantly improved psychological well-being in patients with moderate-to-severe psoriasis, matching general population levels at week 16 and improving further by year 2.”
These findings highlight the importance of targeting both physical and psychological aspects of psoriasis and position tildrakizumab as a therapy that delivers comprehensive, long-term patient benefit.
Reference
Mrowietz U, Sommer R, Reguiai Z, et al. Beyond skin clearance: tildrakizumab improves high burdensome symptoms and psychological well-being in moderate-to-severe psoriasis patients—2-year POSITIVE study results. Presented at: American Academy of Dermatology Annual Meeting; March 27–31, 2026; Denver, Colorado.
