Dose Adjustment of Biologic Treatments for Moderate-to-Severe Plaque Psoriasis in the Real World: A Systematic Review.

Adalimumab Dosing Etanercept Infliximab Plaque psoriasis Secukinumab Ustekinumab

Journal

Dermatology and therapy
ISSN: 2193-8210
Titre abrégé: Dermatol Ther (Heidelb)
Pays: Switzerland
ID NLM: 101590450

Informations de publication

Date de publication:
Aug 2021
Historique:
received: 12 04 2021
pubmed: 4 6 2021
medline: 4 6 2021
entrez: 3 6 2021
Statut: ppublish

Résumé

Dose escalation and reduction of biologic treatments are frequent in clinical practice. The aim of this systematic review is to summarise evidence on dose adjustment of biologic treatments for moderate-to-severe plaque psoriasis in the real-world. A systematic review of real-world evidence on dose adjustment of biologics for plaque psoriasis was performed. Searches were conducted in BIOSIS Previews The search identified 162 papers, and 20 studies with 30,912 patients were included from 2014 to 2020. More studies reported on dose escalation than dose reduction. For adalimumab, 3-54% of patients had dose reduction while 0-37% had dose escalation. For infliximab, only two studies reported a dose reduction, with rates of 22-29%, while dose escalation rates varied from 14 to 67%. Dose reduction rates of 5-49% were reported for etanercept while 0-55% of patients had doses escalated. For ustekinumab, dose escalation and reduction rates ranged from 3 to 37% and 7 to 42%, respectively. Two studies reported on dose adjustment for secukinumab; in one 52% of patients initiated on 150 mg instead of the recommended 300 mg, while another reported no dose increase. Dose adjustment of biologics for psoriasis is common, with escalation more frequently reported than reduction. Dose escalation may have economic and safety consequences, while dose reduction may impact efficacy. These aspects are important to consider when making decisions on treatment dosing.

Identifiants

pubmed: 34081304
doi: 10.1007/s13555-021-00559-z
pii: 10.1007/s13555-021-00559-z
pmc: PMC8322248
doi:

Types de publication

Journal Article Review

Langues

eng

Pagination

1141-1156

Informations de copyright

© 2021. The Author(s).

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Auteurs

Alessio Gambardella (A)

Università degli Studi della Campania "Luigi Vanvitelli", Caserta, Italy.

Gaetano Licata (G)

Università degli Studi della Campania "Luigi Vanvitelli", Caserta, Italy. gaetano.licata89@gmail.com.

Anne Sohrt (A)

LEO Pharma A/S, Ballerup, Denmark.

Classifications MeSH