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Akdogan N, Balan K, Armagan BY, Gulseren D, Dogan S. Psoriatic arthritis, biologic therapy experience, body mass index, and onset age of psoriasis were independent factors of secukinumab discontinuation in patients with psoriasis. Expert Rev Clin Pharmacol 2024:1-8. [PMID: 38994659 DOI: 10.1080/17512433.2024.2378762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 07/08/2024] [Indexed: 07/13/2024]
Abstract
INTRODUCTION Despite the availability of several treatments for psoriasis (PsO), factors influencing the persistence of secukinumab (SEC) therapy remain inadequately understood. This study aimed to identify predictors of SEC persistence in PsO. METHODS A retrospective analysis was conducted on 109 PsO patients who received SEC treatment at least 1 year. Patients were categorized based on continued or discontinued SEC therapy. RESULTS Among the 109 patients, 64 continued SEC treatment while 45 discontinued. Univariate analysis demonstrated that PsA presence and previous biologic therapy use increased the risk of SEC discontinuation 3.56- and 2.33-fold (p = 0.001, %95 CI: 1.66-7.65 and p = 0.032, %95 CI: 1.08-5.04, respectively). Additionally, the risk of SEC discontinuation is 57% higher in patients with a body mass index (BMI) above 26.5 compared to those with a BMI below 26.5 (p = 0.016, %95 CI: 0.22-0.85). Additionally, patients with PsO onset age below 26.5 years were found to have a 2.93-times higher risk of discontinuing SEC compared to those with PsO onset age above 26.5 years (p = 0.004, %95 CI: 1.40-6.13). CONCLUSION PsA presence, previous biologic therapy experience, BMI, and PsO onset age were identified as independent predictors of SEC discontinuation. These findings underscore the importance of personalized treatment strategies for PsO patients receiving SEC therapy.
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Affiliation(s)
- Neslihan Akdogan
- School of Medicine, Department of Dermatology and Venereology, Hacettepe University, Ankara, Turkey
| | - Kerem Balan
- School of Medicine, Department of Dermatology and Venereology, Hacettepe University, Ankara, Turkey
| | - Basak Yalici Armagan
- School of Medicine, Department of Dermatology and Venereology, Hacettepe University, Ankara, Turkey
| | - Duygu Gulseren
- School of Medicine, Department of Dermatology and Venereology, Hacettepe University, Ankara, Turkey
| | - Sibel Dogan
- School of Medicine, Department of Dermatology and Venereology, Hacettepe University, Ankara, Turkey
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Tada Y, Soliman AM, Ishii K, Sakuma R, Pinter A, Davis M, Nunag D, Buessing M, Puig L, Imafuku S. Dose escalation of biologic treatment in patients with moderate-to-severe psoriasis in Japan. Exp Dermatol 2024; 33:e15067. [PMID: 38757460 DOI: 10.1111/exd.15067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 03/11/2024] [Accepted: 03/17/2024] [Indexed: 05/18/2024]
Abstract
Patients receiving interleukin (IL)-inhibiting biologics for moderate-to-severe psoriasis (PsO) may be treated with escalated doses to optimize outcomes. This study evaluated escalation prevalence in a Japanese claims analysis of patients with PsO diagnosis preceding IL-inhibiting biologic treatment and ≥1 post-induction maintenance claim (index date) with sufficient data availability from January 2014 to May 2022. Patients with non-persistence were excluded. Expected daily dose (EDD) was calculated as the recommended maintenance dose divided by the treatment interval. Dose escalation was defined as ≥2 claims showing a ≥20% increase in the observed average daily dose (ADD) over the EDD (with sensitivities requiring ≥1 claim and ≥30%). Significant differences were tested using multivariable regressions. The study included 982 unique patients treated with brodalumab (BRO; n = 104), guselkumab (GUS; n = 207), ixekizumab (IXE; n = 159), risankizumab (RIS; n = 135), secukinumab (SEC; n = 215) and ustekinumab (UST; n = 196). Within 12 months, dose escalation was observed for all IL-inhibiting biologics other than GUS and RIS: 44.4% for UST, 37.2% for IXE, 3.4% for SEC and 1.4% for BRO. In multivariable-adjusted analyses, odds of dose escalation were significantly lower for all products relative to UST. In sensitivities, escalation was observed for all products except RIS.
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Affiliation(s)
- Yayoi Tada
- Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan
| | | | | | | | - Andreas Pinter
- Department of Dermatology, Venereology and Allergology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | | | | | | | - Luis Puig
- Department of Dermatology, IIB SANTPAU, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
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Daudén E, Escario E, Martos-Cabrera L, Armesto S, Herrera-Acosta E, Vidal D, Vilarrasa E, Rivera R, de la Cueva P, Martorell A, Ballesca F, Belinchón I, Carretero G, Rodríguez L, Romero-Maté A, Pujol-Montcusí J, Salgado L, Sahuquillo-Torralba A, Coto-Segura P, Baniandrés O, Feltes R, Riera-Monroig J, Garrido J, Llamas-Velasco M. Dose reduction is a feasible strategy in patients with plaque psoriasis who achieve sustained response with secukinumab: a retrospective, multicenter cohort study in daily practice setting. Int J Dermatol 2024; 63:503-511. [PMID: 38168847 DOI: 10.1111/ijd.16915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 10/16/2023] [Accepted: 11/08/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Biological therapy dose modification is a common practice in the long-term treatment of plaque psoriasis. OBJECTIVE The objective of the study was to determine prevalence, characteristics of patients, effectiveness, treatment survival of secukinumab dose reduction (SEC-DR) strategy and assess its safety and cost implications. METHODS A retrospective, observational, multicenter cohort study was conducted in patients with plaque psoriasis treated with secukinumab and up to 2 years of follow-up. RESULTS In 63/347 patients with an initial standard dose regimen, SEC-DR was tried at any moment in 18.2% of them after sustained response. In 51 patients, the interval between administrations was increased while in 12 patients, monthly dose was reduced to 150 mg. Successful SEC-DR was achieved in 77.8% of the patients, with sustained PASI response to the end of the study. Survival of secukinumab treatment and safety profile were not compromised by DR. The use of DR saved 33% of the cost, including failures in which standard treatment was resumed. LIMITATIONS The proper of the study designed and the arbitrary definition of "DR success." CONCLUSION Off-label SEC-DR strategy was used in patients with sustained response to standard dose regimen; this strategy showed long-term efficacy without compromising treatment survival or worsening the safety profile while also being cost saving.
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Affiliation(s)
- Esteban Daudén
- Hospital Universitario de la Princesa. Instituto de Investigación Sanitaria la Princesa (IIS-IP), Madrid, Spain
| | - Elena Escario
- Hospital Universitario de la Princesa. Instituto de Investigación Sanitaria la Princesa (IIS-IP), Madrid, Spain
| | - Luisa Martos-Cabrera
- Hospital Universitario de la Princesa. Instituto de Investigación Sanitaria la Princesa (IIS-IP), Madrid, Spain
| | - Susana Armesto
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | - David Vidal
- Hospital de Sant Joan Despí Moisés Broggi, Barcelona, Spain
| | - Eva Vilarrasa
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | | | | | - Ferran Ballesca
- Hospital Universitario Germans Trias i Pujol, Barcelona, Spain
| | - Isabel Belinchón
- Hospital General Universitario de Alicante - ISABIAL, Alicante, Spain
| | | | | | | | - J Pujol-Montcusí
- Hospital Universitario de Tarragona "Joan XXIII", Tarragona, Spain
| | - Laura Salgado
- Complejo Hospitalario Universitario, Pontevedra, Spain
| | | | | | | | - R Feltes
- Hospital Universitario la Paz, Madrid, Spain
| | | | | | - Mar Llamas-Velasco
- Hospital Universitario de la Princesa. Instituto de Investigación Sanitaria la Princesa (IIS-IP), Madrid, Spain
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Hussain AB, Hampton PJ. Improving the Accuracy of Biologic Drug Survival Data: The Increasing Prevalence of Off-Label Dosing Must Be Considered when Reporting Drug Effectiveness and Safety. J Invest Dermatol 2023; 143:2096-2098. [PMID: 37330717 DOI: 10.1016/j.jid.2023.04.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 04/30/2023] [Indexed: 06/19/2023]
Affiliation(s)
- Amaani B Hussain
- Department of Dermatology, The Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
| | - Philip J Hampton
- Department of Dermatology, The Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom; Newcastle Biomedical Research Centre, Newcastle upon Tyne, England.
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Girolomoni G, Savage L, Gisondi P, Svensson Å, Mahé E, Augustin M, Puig L. Increasing Access to Effective Systemic Treatments in Patients with Moderate-to-Severe Psoriasis: Narrative Review. Dermatol Ther (Heidelb) 2023; 13:2171-2185. [PMID: 37710078 PMCID: PMC10539267 DOI: 10.1007/s13555-023-01014-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/14/2023] [Indexed: 09/16/2023] Open
Abstract
Psoriasis is a chronic, immune-mediated inflammatory disease with a worldwide prevalence ranging between 0.51 and 11.43%. It results in a large clinical and social burden, with patients frequently suffering from reduced quality of life, psychologic distress and debilitating comorbidities. Biologic agents are used to establish and maintain disease control in patients with moderate-to-severe psoriasis and are essential to improving quality of life. However, a substantial proportion of patients have limited access to therapy due to economics, health policies and clinical considerations, which creates clinical unmet needs that disadvantage both patients and healthcare professionals. Biosimilars are a cost-effective alternative to off-patent biologic therapies, and there is mounting evidence to suggest they offer a valuable pharmacoeconomic strategy to lower healthcare costs in patients with psoriasis. Furthermore, the introduction of biosimilars can increase the number of patients able to receive biologics, allowing these patients to be treated earlier in the disease course, potentially modifying the course of their disease and reducing the risk of comorbidities. In time, the emergence of additional data, particularly those related to long-term safety, efficacy in extrapolated indications and the effects of switching, should reassure physicians and help overcome the final hurdles for a wider implementation of biosimilars. This review aims to provide an overview of current treatment approaches for patients with moderate-to-severe psoriasis in the biosimilars era and explores both the current challenges and potential opportunities to improve access to high-quality, effective treatments.
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Affiliation(s)
- Giampiero Girolomoni
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
| | - Laura Savage
- Department of Dermatology, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Paolo Gisondi
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
| | - Åke Svensson
- Department of Dermatology, Institute of Clinical Research in Malmö, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Emmanuel Mahé
- Department of Dermatology and Venereology, Department of Medicine, Hospital Victor-Dupouy, Argenteuil, France
| | - Matthias Augustin
- University Medical Center Hamburg-Eppendorf, Institute for Health Services Research in Dermatology and Nursing, Hamburg, Germany
| | - Luis Puig
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau-Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
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Nyholm N, Danø A, Schnack H, Colombo GL. The Cost-Effectiveness of Anti-IL17 Biologic Therapies for Moderate-to-Severe Plaque Psoriasis Treatment in Italy and Germany: A Sequential Treatment Analysis. CLINICOECONOMICS AND OUTCOMES RESEARCH 2023; 15:607-619. [PMID: 37533798 PMCID: PMC10392902 DOI: 10.2147/ceor.s417922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/15/2023] [Indexed: 08/04/2023] Open
Abstract
Objective The objective of this study was to optimise the cost-effectiveness of different anti-IL17 treatment sequences used in the treatment of moderate-to-severe plaque psoriasis in Italy and Germany over a five-year time horizon. Methods We adjusted a previously published treatment sequence model for biologic drugs used in psoriasis treatment to an Italian and German setting, respectively. The model included all anti-IL17 biologics currently available in the treatment of moderate-to-severe plaque psoriasis in the markets of scope (secukinumab, ixekizumab, brodalumab and bimekizumab). Real-world discontinuation rates were used to model switches between the four anti-IL17 biologics included in the study. The treatment costs were based on label dosing recommendations for each drug, including induction and maintenance therapy, and the manufacturer prices of each drug in Italy and Germany, respectively. We used long-term Psoriasis Area and Severity Index 100 (PASI100) measures to inform the model on the efficacy for each treatment. The cost-effectiveness in the analysis was evaluated based on the cost per PASI100-responder. Results We found that the most cost-effective treatment sequence was achieved by using brodalumab as first-line treatment, bimekizumab as second-line treatment, ixekizumab as third-line treatment and secukinumab as fourth-line treatment in both Italy and Germany, which resulted in a total cost per responder of €128,200 and €138,212, respectively, over a five-year period. Several scenario analyses were also conducted and ensured that the results were robust to changes in key input parameters. Conclusion Our study showed that using brodalumab as a first-line therapy to treat moderate-to-severe psoriasis in both Italy and Germany leads to the most cost-effective treatment sequence, when compared to all possible combinations of anti-IL17s over a five-year time horizon. In addition, we found that treatment discontinuation and switching are important factors when assessing the cost-effectiveness of biologic therapies.
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Affiliation(s)
| | | | | | - Giorgio Lorenzo Colombo
- CEFAT Center of Pharmaceuticals Economics and Medical Technologies Evaluation, Department of Drug Sciences, University of Pavia, Pavia, Italy
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Demirel Öğüt N, Koç Yıldırım S, Erbağcı E, Hapa FA. Ixekizumab treatment in patients with moderate-to-severe plaque psoriasis in a real-world clinical setting. J Cosmet Dermatol 2022; 21:6215-6224. [PMID: 35801372 DOI: 10.1111/jocd.15217] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/29/2022] [Accepted: 07/04/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND The efficacy and safety reports of ixekizumab for moderate-to-severe plaque psoriasis may vary between clinical trials and real-world studies. AIM To analyze the real-world data of ixekizumab therapy to evaluate its efficacy and safety and highlight the factors influencing the treatment response in the real-world scenario. PATIENTS/METHODS Data of 82 adult patients with moderate-to-severe chronic plaque psoriasis are included in this study. Psoriasis area severity index (PASI) 75/90/100 responses at 4, 16, 24, and 48 weeks were analyzed retrospectively from patient charts by examining demographic and clinical characteristics of the patients, especially their previous biologic experience, obesity, and involvement of hard-to-treat areas. RESULTS PASI75, PASI90, and PASI100 responses were achieved in 92.4%, 86.1%, and 26.6% patients at week 16 and maintained till week 48 in 92.3%, 86.5%, and 17.3% patients. PASI90 responses in obese patients were significantly lower than non-obese patients at week 4 (33.3% vs. 69.6%, p = 0.042), but this difference was minimized by week 16 (82.4% vs. 90%, p = 0.405). PASI90 responses in biologic-naive patients were significantly higher than biologic-experienced patients at week 16 (p = 0.015). Involvement of hard-to-treat areas was negatively associated with PASI90 responses at week 16 (OR: 1591805.842; 95% CI: 1.223-2071404486740.201; p = 0.047). CONCLUSION Ixekizumab provides an effective and safe biologic treatment option to patients with moderate-to-severe plaque psoriasis. Obesity, though it affects the early treatment response (till week 4), does not upset the overall treatment response beyond week 16. Previous biologic exposure and involvement of hard-to-treat areas are important prognostic factors for achieving high PASI responses in psoriatic patients.
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Affiliation(s)
- Neslihan Demirel Öğüt
- Department of Dermatology and Venereology, Uşak Training and Research Hospital, Uşak, Turkey
| | - Sema Koç Yıldırım
- Department of Dermatology and Venereology, Uşak Training and Research Hospital, Uşak, Turkey
| | - Ece Erbağcı
- Department of Dermatology and Venereology, Uşak Training and Research Hospital, Uşak, Turkey
| | - Fatma Aslı Hapa
- Department of Dermatology and Venereology, İzmir Democracy University, İzmir, Turkey
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Zhang X, Tian C, Tian C, Cheng J, Mao W, Li M, Chen M. LTBP2 inhibits prostate cancer progression and metastasis via the PI3K/AKT signaling pathway. Exp Ther Med 2022; 24:563. [PMID: 36034756 PMCID: PMC9400130 DOI: 10.3892/etm.2022.11500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/11/2022] [Indexed: 12/02/2022] Open
Abstract
Biochemical recurrence (BCR) is a cause of concern in advanced prostate cancer (PCa). Thus, novel diagnostic biomarkers are required to improve clinical care. However, research on PCa immunotherapy is also scarce. Hence, the present study aimed to explore promising BCR-related diagnostic biomarkers, and their expression pattern, prognostic value, immune response effects, biological functions, and possible molecular mechanisms were evaluated. GEO datasets (GSE46602, GSE70768, and GSE116918) were downloaded and merged as the training cohort, and differential expression analysis was performed. Lasso regression and SVM-RFE algorithm, as well as PPI analysis and MCODE algorithm, were then applied to filter BCR-related biomarker genes. The CIBERSORT and estimation of stromal and immune cells in malignant tumor tissues using expression data (ESTIMATE) methods were used to calculate the fractions of tumor-infiltrating immune cells. GO/DO enrichment analyses were used to identify the biological functions. The expression of latent transforming growth factor β-binding protein 2 (LTBP2) was determined by RT-qPCR and western blotting. The role of LTBP2 in PCa was determined by CCK-8, Transwell, and the potential mechanism was investigated by KEGG and GSEA and confirmed by western blotting. In total, 44 BCR-related differentially expressed genes (DEGs) in the training cohort were screened. LTBP2 was found to be a diagnostic biomarker of BCR in PCa and was associated with CD4+ T-cell infiltration and response to anti-PD-1/PD-L1 immunotherapy. Subsequently, using the ESTIMATE algorithm, it was identified that LTBP2 was associated with the tumor microenvironment and could be a predictor of the clinical benefit of immune checkpoint blockade. Finally, the expression and biological function of LTBP2 were evaluated via cellular experiments. The results showed that LTBP2 was downregulated in PCa cells and inhibited PCa proliferation and metastasis via the PI3K/AKT signaling pathway in vitro. In conclusion, LTBP2 was a promising diagnostic biomarker of BCR of PCa and had an important role in CD4+ T-cell recruitment. Moreover, it was associated with immunotherapy in patients with PCa who developed BCR, and it inhibited PCa proliferation and metastasis via the PI3K/AKT signaling pathway in vitro.
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Affiliation(s)
- Xiaowen Zhang
- Department of Urology, Affiliated Zhongda Hospital of South‑East University, Nanjing, Jiangsu 210009, P.R. China
| | - Chuanjie Tian
- Department of Urology, Langxi County People's Hospital, Xuancheng, Anhui 242100, P.R. China
| | - Chuanjie Tian
- Department of Urology, Langxi County People's Hospital, Xuancheng, Anhui 242100, P.R. China
| | - Jianbin Cheng
- Department of Urology Surgery, Heqiao Hospital, Yixing, Jiangsu 214200, P.R. China
| | - Weipu Mao
- Department of Urology, Affiliated Zhongda Hospital of South‑East University, Nanjing, Jiangsu 210009, P.R. China
| | - Menglan Li
- NHC Contraceptives Adverse Reaction Surveillance Center, Jiangsu Health Development Research Center, Nanjing, Jiangsu 210036, P.R. China
| | - Ming Chen
- Department of Urology, Affiliated Zhongda Hospital of South‑East University, Nanjing, Jiangsu 210009, P.R. China
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Soenen R, Wang Z, Grine L, Dreesen E, Schots L, Brouwers E, Declerck P, Thomas D, Lambert J. Therapeutic drug monitoring in dermatology: the way towards dose optimization of secukinumab in chronic plaque psoriasis. Clin Exp Dermatol 2022; 47:1324-1336. [PMID: 35245966 PMCID: PMC9320967 DOI: 10.1111/ced.15157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 02/11/2022] [Accepted: 02/27/2022] [Indexed: 12/02/2022]
Abstract
Background Despite the favourable efficacy profile of secukinumab, clinicians encounter varying clinical responses among patients potentially associated with under‐ and overdosing. As biologics are expensive, their rational use is crucial and evident. Therapeutic drug monitoring could guide clinicians in making decisions about treatment modifications. Aim In this multicentre, prospective study, we aimed to develop and validate a secukinumab immunoassay and searched for the therapeutic window in patients with psoriasis. Methods We determined secukinumab concentrations at trough in sera from 78 patients with psoriasis at multiple timepoints (Weeks 12, 24, 36, 48 and 52; after Week 52, measurements could be taken at an additional three timepoints) during maintenance phase, using an in‐house secukinumab immunoassay consisting of a combination of MA‐SEC66A2 as capture antibody and MA‐SEC67A9, conjugated to horseradish peroxidase, as detecting antibody. At each hospital visit, disease severity was assessed using the Psoriasis Area and Severity Index (PASI). Results After quantification, 121 serum samples were included for dose–response analysis. Based on a linear mixed‐effects model, secukinumab trough concentrations were found to decrease with increasing body mass index (BMI). Based on receiver operating characteristic (ROC) analysis, we concluded that the minimal effective secukinumab threshold was 39.1 mg/L in steady state, and that this was associated with a 92.7% probability of having an optimal clinical response (PASI ≤ 2 or reduction in PASI of ≥ 90%). Conclusions Monitoring and targeting a secukinumab trough concentration of 39.1 mg/L may be a viable treatment option in suboptimal responders. In patients with higher BMI, weight‐based dosing may be needed in order to prevent underdosing.
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Affiliation(s)
- Rani Soenen
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium.,Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Zhigang Wang
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Lynda Grine
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
| | - Erwin Dreesen
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Lisa Schots
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
| | - Els Brouwers
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Paul Declerck
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Debby Thomas
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Jo Lambert
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
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