Patient's Perspective on the Impact of Psoriasis on Their Quality of Life After 1 Year of Tildrakizumab Treatment: Despite Clinical Improvement, Persistence of a Potential Mental Cicatricial Memory of the Disease

ABSTRACT Background Tildrakizumab showed high efficacy and safety for treating moderate‐to‐severe psoriasis in clinical trials. The development of biologics to treat psoriasis has allowed us to aim for increasingly ambitious objectives. However, patients' and physicians' perspectives on therapeutic goals and satisfaction concerning treatments may sometimes differ. Objectives To analyze the efficacy and safety of tildrakizumab and the impact of the psoriasis improvement regarding the physicians' and patients' point of view, in daily practice, after 1 year of treatment. Methods A prospective multicentric study was conducted in patients who were initiated with tildrakizumab for moderate‐to‐severe psoriasis. Assessments of psoriasis and its impact on patients' lives were performed at tildrakizumab initiation and after 6 and 12 months of treatment. Results At baseline, psoriasis deeply affected patients' lives, with 42% showing signs of clinical depression and 34.6% experiencing genital involvement with significant impact on their sex life. After 1 year, tildrakizumab was, overall, effective and safe, even in difficult‐to‐treat areas. Psoriasis Area Severity Index score decreased from 13.6 to 2.3, SF12‐mental component score improved from 41 to 48.7 and Dermatology Life Quality Index dropped from 10.4 to 2.5. Despite these improvements, some patients remained dissatisfied, expressing concerns about relapse and persistence of mental impact of the disease over the long term. Conclusions Tildrakizumab confirmed its efficacy and safety for the treatment of moderate‐to‐severe psoriasis. However, despite good control of their disease, some patients remained dissatisfied, over the long time, raising the issue of the cumulative mental impact of a disease left with no effective treatment for too long before the initiation of an effective treatment. These findings suggest that early treatment of psoriasis with effective therapies is important not only to target tissue‐resident memory T cells, as indicated by recent studies, but also to potentially address patients' cicatricial memory of their disease.