Long-Term Dose Optimization of Adalimumab via Dose Spacing in Patients with Psoriasis

Dose spacing (DS) can be useful for optimizing treatment with biologics in psoriasis patients. However, interval prolongation might increase the production of anti-drug antibodies (ADA) and, therefore, reduce the drug’s effectiveness. The long-term effects of DS with adalimumab in psoriatic patients...

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Bibliographic Details
Published in:Bioengineering (Basel) 2022-08, Vol.9 (8), p.387
Main Authors: Benzaquen, Michael, Munshi, Mohammad, Bossart, Simon, Feldmeyer, Laurence, Emelianov, Vladimir, Yawalkar, Nikhil, Cazzaniga, Simone, Heidemeyer, Kristine
Format: Article
Language:English
Subjects:
Adalimumab
Advisors
Antibodies
Bioengineering
Biological products
Body mass index
Communication
Conflicts of interest
Decision making
Dosage and administration
dose optimization
dose spacing
Drug dosages
Drug therapy
Effectiveness
inflammatory skin diseases
Informed consent
Laboratories
long term
Long-term effects
Monoclonal antibodies
Optimization
Patients
Prolongation
Psoriasis
Psoriatic arthritis
Tumor necrosis factor-α
Values
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Summary:Dose spacing (DS) can be useful for optimizing treatment with biologics in psoriasis patients. However, interval prolongation might increase the production of anti-drug antibodies (ADA) and, therefore, reduce the drug’s effectiveness. The long-term effects of DS with adalimumab in psoriatic patients have not been reported. The goal of our study was to evaluate the long-term follow-up of psoriatic patients after adalimumab DS regarding the clinical course and determination of circulating adalimumab, TNFα levels, and anti-adalimumab antibodies. We retrospectively included seven patients treated with adalimumab for moderate-to-severe psoriasis and benefiting from DS from 2010 to 2021. The dose interval of adalimumab was extended to three weeks for all patients and then to four weeks for three of the seven patients. Adalimumab trough levels, TNFα levels, and ADA against adalimumab were measured. For six of the seven patients, absolute PASI values remained below 3 throughout the follow-up period (median = 8.0 years; range: 1.7−11.5) after DS. All the patients were satisfied with the effectiveness of their treatment regime. Within the follow-up period, an average of 63 doses of adalimumab per patient were spared. The median adalimumab trough levels were 4.7 µg/mL (range: 1.9−12.5). TNFα levels remained under 10 pg/mL (undetectable) in all except one patient. ADA against adalimumab remained negative (
ISSN:2306-5354
2306-5354
DOI:10.3390/bioengineering9080387