Real world use of biologic drug levels and anti-drug antibodies in patients with psoriasis – does therapeutic drug monitoring have a place in routine clinical practice?
Background: Psoriasis is a chronic disorder with increasing new treatments targeting the T-helper cell (Th)-1/Th17 axis. There remains a subset of patients who experience a primary or secondary failure to biologic treatments. Methods: We present ten patients with psoriasis who failed biologic therap...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2022-04-01
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| Series: | Journal of Dermatological Treatment |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/09546634.2021.1898526 |
| _version_ | 1797683536100065280 |
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| author | Niamh Kearney Kevin McKenna |
| author_facet | Niamh Kearney Kevin McKenna |
| author_sort | Niamh Kearney |
| collection | DOAJ |
| description | Background: Psoriasis is a chronic disorder with increasing new treatments targeting the T-helper cell (Th)-1/Th17 axis. There remains a subset of patients who experience a primary or secondary failure to biologic treatments. Methods: We present ten patients with psoriasis who failed biologic therapy with measurement of serum drug levels and anti-drug antibody levels (ADAs) with review of the current literature. Our objective was to identify demographic factors, disease status, drug level and ADAs which might correlate with primary and secondary failure. Results: There are a number of factors affecting drug levels in patients with psoriasis on biologics including the presence of ADAs, patient adherence to treatment regimes, pharmacogenetics and the pharmacokinetic properties of the drug following subcutaneous injection. Our results demonstrate that biologic failure is related to low serum drug levels subtherapeutic in 80% of our cohort. Primary failure may correlate with the presence of ADAs but not with serum drug levels. All patients were ANA negative and there remains considerable debate on the utility of routine ANA testing. Conclusions: The role of therapeutic drug monitoring in dermatology remains uncertain and requires further study. We aim to promote debate in the dermatology community as to the utility of therapeutic drug monitoring in routine practice. |
| first_indexed | 2024-03-12T00:16:18Z |
| format | Article |
| id | doaj.art-c675a4159acd48dd8e16ff693210c7dd |
| institution | Directory Open Access Journal |
| issn | 0954-6634 1471-1753 |
| language | English |
| last_indexed | 2024-03-12T00:16:18Z |
| publishDate | 2022-04-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Dermatological Treatment |
| spelling | doaj.art-c675a4159acd48dd8e16ff693210c7dd2023-09-15T14:28:50ZengTaylor & Francis GroupJournal of Dermatological Treatment0954-66341471-17532022-04-013331676168110.1080/09546634.2021.18985261898526Real world use of biologic drug levels and anti-drug antibodies in patients with psoriasis – does therapeutic drug monitoring have a place in routine clinical practice?Niamh Kearney0Kevin McKenna1Department of Dermatology, Belfast City HospitalDepartment of Dermatology, Belfast City HospitalBackground: Psoriasis is a chronic disorder with increasing new treatments targeting the T-helper cell (Th)-1/Th17 axis. There remains a subset of patients who experience a primary or secondary failure to biologic treatments. Methods: We present ten patients with psoriasis who failed biologic therapy with measurement of serum drug levels and anti-drug antibody levels (ADAs) with review of the current literature. Our objective was to identify demographic factors, disease status, drug level and ADAs which might correlate with primary and secondary failure. Results: There are a number of factors affecting drug levels in patients with psoriasis on biologics including the presence of ADAs, patient adherence to treatment regimes, pharmacogenetics and the pharmacokinetic properties of the drug following subcutaneous injection. Our results demonstrate that biologic failure is related to low serum drug levels subtherapeutic in 80% of our cohort. Primary failure may correlate with the presence of ADAs but not with serum drug levels. All patients were ANA negative and there remains considerable debate on the utility of routine ANA testing. Conclusions: The role of therapeutic drug monitoring in dermatology remains uncertain and requires further study. We aim to promote debate in the dermatology community as to the utility of therapeutic drug monitoring in routine practice.http://dx.doi.org/10.1080/09546634.2021.1898526psoriasisbiologic drugsanti-drug antibodiesdrug levelsanabiologic failure |
| spellingShingle | Niamh Kearney Kevin McKenna Real world use of biologic drug levels and anti-drug antibodies in patients with psoriasis – does therapeutic drug monitoring have a place in routine clinical practice? Journal of Dermatological Treatment psoriasis biologic drugs anti-drug antibodies drug levels ana biologic failure |
| title | Real world use of biologic drug levels and anti-drug antibodies in patients with psoriasis – does therapeutic drug monitoring have a place in routine clinical practice? |
| title_full | Real world use of biologic drug levels and anti-drug antibodies in patients with psoriasis – does therapeutic drug monitoring have a place in routine clinical practice? |
| title_fullStr | Real world use of biologic drug levels and anti-drug antibodies in patients with psoriasis – does therapeutic drug monitoring have a place in routine clinical practice? |
| title_full_unstemmed | Real world use of biologic drug levels and anti-drug antibodies in patients with psoriasis – does therapeutic drug monitoring have a place in routine clinical practice? |
| title_short | Real world use of biologic drug levels and anti-drug antibodies in patients with psoriasis – does therapeutic drug monitoring have a place in routine clinical practice? |
| title_sort | real world use of biologic drug levels and anti drug antibodies in patients with psoriasis does therapeutic drug monitoring have a place in routine clinical practice |
| topic | psoriasis biologic drugs anti-drug antibodies drug levels ana biologic failure |
| url | http://dx.doi.org/10.1080/09546634.2021.1898526 |
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