{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T06:04:48Z","timestamp":1784009088989,"version":"3.55.0"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background\/Objectives<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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\u201312 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1788690","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T05:37:48Z","timestamp":1784007468000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Real-life experience of tildrakizumab 200 mg in complex psoriatic patients: a case series"],"prefix":"10.3389","volume":"13","author":[{"given":"Giulia","family":"Odorici","sequence":"first","affiliation":[{"name":"Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara","place":["Ferrara, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cinzia","family":"Buligan","sequence":"additional","affiliation":[{"name":"Institute of Dermatology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC)","place":["Udine, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Fantini","sequence":"additional","affiliation":[{"name":"Section of Dermatology, Department of Medicine and Surgery, University of Parma","place":["Parma, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Mantovani","sequence":"additional","affiliation":[{"name":"Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara","place":["Ferrara, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Rech","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Psoriasis Outpatient Service, APSS","place":["Trento, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lidia","family":"Sacchelli","sequence":"additional","affiliation":[{"name":"Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna","place":["Bologna, Italy"]},{"name":"Department of Medical and Surgical Sciences Alma Mater Studiorum, University of Bologna","place":["Bologna, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1945","DOI":"10.1001\/jama.2020.4006","article-title":"Pathophysiology, clinical presentation, and treatment of psoriasis: a review","volume":"323","year":"2020","journal-title":"JAMA"},{"key":"B2","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1080\/14712598.2024.2325547","article-title":"Tildrakizumab: the value of a personalized and flexible approach for treating moderate-to-severe plaque psoriasis in patients with high body weight or high disease burden","volume":"24","author":"Dapavo","year":"2024","journal-title":"Expert Opin Biol Ther."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1555","DOI":"10.1007\/s13555-025-01393-3","article-title":"Management of challenging psoriasis clinical scenarios","volume":"15","author":"Stein Gold","year":"2025","journal-title":"Dermatol Ther."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1173","DOI":"10.1001\/jamadermatol.2013.5015","article-title":"Psoriasis severity and the prevalence of major medical comorbidity: a population-based study","volume":"149","author":"Yeung","year":"2013","journal-title":"JAMA Dermatol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.23736\/S2784-8671.21.07132-2","article-title":"Italian adaptation of EuroGuiDerm guideline on the systemic treatment of chronic plaque psoriasis","volume":"157","author":"Gisondi","year":"","journal-title":"Ital J Dermatol Venerol. 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