Psoriasis: how does biologic dose reduction compare with usual care?

  • Atalay S & al.
  • JAMA Dermatol
  • 12 Feb 2020

  • curated by Brian Richardson, PhD
  • Clinical Essentials
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Takeaway

  • Dose reduction of the biologic therapies adalimumab, etanercept, and ustekinumab demonstrated noninferiority to usual care for QoL, but not disease activity, in this randomized clinical trial.

Why this matters

  • Achieving the lowest effect dose may help reduce the risk for and financial burden of biologic therapy.

Key results

  • 53% of patients in the dose-reduction group successfully tapered their dose at 12 months, with no related serious adverse events reported.
  • Dose reduction did not meet the noninferiority criteria for disease activity at 12 months compared with usual care (mean Psoriasis Area and Severity Index, 3.4 vs 2.1).
  • Dose reduction met noninferiority criteria for QoL at 12 months compared with usual care (median Dermatology Life Quality Index score, 1.0 vs 0.0).
  • Dose reduction and usual care were associated with a similar number of persistent flares (5 in each group).

Study design

  • 111 patients with plaque psoriasis and stable low disease activity, 53 who underwent dose reduction and 58 who maintained usual care, were included.
  • Funding: ZonMw.

Limitations

  • Open-label design.