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Proactive TDM Versus Standard Use of Biologics in Psoriasis
Sponsor: University Hospital, Ghent
Summary
Biologics are effective agents for the treatment of psoriasis. The newest generation of biologics block interleukin 17 and 23. Physicians always prescribe these drugs in a fixed dose, but this may lead to under- and overdosing in some patients. Underdosing may lead to inadequate response or loss of response over time. Overdosage, on the other hand, can lead to higher risk of side effects and higher costs for the healthcare system. In daily clinical practice, physicians often tackle this real-world issue by blind trial- and- error dose modifications or switching to another biologic. In this study, we want to rationalize these dose modifications and optimize dosing based on the drug concentrations, measured in the blood of the patient (i.e. therapeutic drug monitoring). Depending on the drug concentration, the interval between injections will be lengthened or shortened with the aim to reach the required drug concentration to reach the best clinical result. The trial will be conducted in 14 Belgian hospitals where patients will be divided into 2 study groups: a group that will be advised on the dosing scheme of their biologic based on the measured drug concentration and a group that continues dosing as in daily clinical practice. We will monitor if the clinical response and quality of life remains stable. With this study, we will track drug concentrations as we believe that they can guide dosing of biologics and we hope to achieve better safety, lower healthcare expenses and higher patients' treatment satisfaction while striving for the best clinical response.
Official title: Proactive Therapeutic Drug Monitoring Versus Routine Care With the Novel Biologics in Psoriasis : a Pragmatic, Multicentric, Randomised, Controlled Study
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
210
Start Date
2024-12-20
Completion Date
2028-03-01
Last Updated
2026-03-04
Healthy Volunteers
No
Conditions
Interventions
Proactive TDM-based dosing of secukinumab
Maintenance/normal dose is 300 mg/4 weeks or 300 mg/ month First dose reduction step: 300 mg/6 weeks. Second dose reduction step: 300 mg/8 weeks. Further dose reduction steps: prolongation with 1 additional week First dose escalation step: 300 mg/3 weeks Second dose escalation step: 300 mg/2 weeks Further dose escalation step: shortening with 1 additional week
Proactive TDM-based dosing of ixekizumab
Maintenance/normal dose is 80 mg/4 weeks. First dose reduction step: 80 mg/6 weeks. Second dose reduction step: 80 mg/8 weeks Further dose reduction steps: prolongation with 1 additional week First dose escalation step: 80 mg/3 weeks Second dose escalation step: 80 mg/2 weeks Further dose escalation step: shortening with 1 additional week
Proactive TDM-based dosing of guselkumab
Maintenance/normal dose is 100 mg/8 weeks. First dose reduction step: 100 mg/12 weeks. Second dose reduction step: 100 mg/16 weeks. Further dose reduction steps: prolongation with 1 additional week First dose escalation step: 100 mg/6 weeks Second dose escalation step: 100 mg/4 weeks Further dose escalation step: shortening with 1 additional week
Locations (15)
AZ Sint-Jan
Bruges, Belgium
CHU Saint-Pierre
Brussels, Belgium
UCL Saint-Luc
Brussels, Belgium
ULB Erasme
Brussels, Belgium
UZ Brussel
Brussels, Belgium
Grand Hôpital de Charleroi
Charleroi, Belgium
AZ Alma
Eeklo, Belgium
Dermatologiepraktijk huidziekten Geel
Geel, Belgium
AZ Maria Middelares
Ghent, Belgium
UZ Gent
Ghent, Belgium
Clinique André Renard
Herstal, Belgium
Dermatologie Handelskaai
Kortrijk, Belgium
UZ Leuven
Leuven, Belgium
CHU Liège
Liège, Belgium
Dermatologie Maldegem
Maldegem, Belgium