I have had two different TPMS systems and have found the pressure they read out to be within 2 psi of my pressure gauge.
While traveling I watch for a tire pressure that is much different from the others. After about 10 miles of towing I find all four of my trailer tires are usually within 2-3 psi if they were all the same before the trip.
I had one that was about 5 psi lower than the other 4 on my trailer. I pulled over at the next gas station and found a 3/8 x 2 inch machine bolt in the tire that was indicating low. The TPMS saved me from having a total tire failure which surely would have damaged the trailer.
The TPMS may not agree with a high quality pressure gauge but what is important is the TPMS is usually consistent and will let you know if a tire is losing pressure while under way.
Also more convenient to check pressures early in the morning before each trip.