Serum drug levels and anti-drug antibodies in the context of dose tapering by interval prolongation of adalimumab, etanercept and ustekinumab in psoriasis patients: results of the CONDOR trial
Publication year
2022Source
Journal of Dermatological Treatment, 33, 5, (2022), pp. 2680-2684ISSN
Publication type
Article / Letter to editor
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Organization
Dermatology
Health Evidence
Rheumatology
Journal title
Journal of Dermatological Treatment
Volume
vol. 33
Issue
iss. 5
Page start
p. 2680
Page end
p. 2684
Subject
Radboudumc 13: Stress-related disorders DCMN: Donders Center for Medical Neuroscience; Radboudumc 5: Inflammatory diseases RIHS: Radboud Institute for Health Sciences; Health Evidence - Radboud University Medical Center; Rheumatology - Radboud University Medical CenterAbstract
BACKGROUND: Biologics for psoriasis are registered in standard dosages. In patients with low disease activity, reduction of the dose by interval prolongation can prevent overtreatment, and lower risks and costs. However, fear for increased anti-drug antibody (ADA) formation due to interval prolongation of biologics is an important barrier. OBJECTIVE: To investigate the course of serum drug concentrations, ADA levels, and predictors for successful dose reduction of adalimumab, ustekinumab, and etanercept for psoriasis. METHODS: Patients were randomized to dose reduction (DR) or usual care (UC) and followed for one year. The course and extent of detectable ADA levels were expressed as proportions/relative risks for DR vs. UC. Association of baseline characteristics with successful tapering was investigated with log-binomial regression analysis. RESULTS: In total, 118 patients were included. In adalimumab-treated patients, no significant difference in the proportion of patients with relevant ADA levels in DR vs. UC was seen. For ustekinumab, relevant ADA development was absent in both groups. Baseline trough levels were not predictive for successful DR. CONCLUSIONS: Immunogenicity may not increase by interval prolongation in psoriasis patients with low disease activity. This pilot provides important and reassuring insight into the pharmacological changes after dose tapering of adalimumab, etanercept, and ustekinumab.
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- Academic publications [246216]
- Electronic publications [133861]
- Faculty of Medical Sciences [93266]
- Open Access publications [107344]
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