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One-third of psoriatic arthritis patients are not receiving optimal dosing of adalimumab
Date:6/11/2014

tive patients with PsA prescribed adalimumab, 36 (35%) appeared to be receiving less than optimal dosing, with a trough adalimumab concentration below 5 mg/L (the lowest point of this ideal dose range). A substantial group of PsA patients that use adalimumab are therefore not able to profit from its optimal clinical benefit," Vogelzang concluded.

This was a prospective cohort study in which 103 consecutive patients diagnosed with PsA were treated with 40 mg adalimumab subcutaneously every other week. Adalimumab concentrations at 28 weeks of treatment were measured in serum trough samples, using an enzyme linked immunosorbent assay (ELISA). Clinical response was defined as a change in disease activity score in 28 joints (ΔDAS28) between baseline and week 28. At 28 weeks of treatment, serum trough concentrations ranged from 0.0 to 18.8 mg/L, with a mean of 7.2 mg/L. In 48 (47%), trough adalimumab concentrations exceeded the optimal threshold of 8 mg/L.

Low dosing of infliximab does not appear to alter treatment response or adherence

International guidelines recommend that patients with arthritis PsA prescribed the TNFα inhibitor infliximab should be dosed with 5 mg/kg bodyweight every 8th week. However, responses to lower doses have not been previously well documented.2

Dr Bente Glintborg of the Copenhagen Centre for Arthritis Research, and Centre for Rheumatology and Spine Diseases, Glostrup Hospital, Denmark presented the clinical outcomes in a large cohort of TNFα inhibitor-nave PsA patients treated with infliximab, stratified by country (Denmark vs. Iceland), and by their dose regimen and escalation.

"More than 70% of Icelandic and Danish PsA patients treated with infliximab received sustained doses below the recommended 5 mg/kg every eight weeks," said Dr Glintborg. "Lower start doses did not appear to affect either drug adherence or response," she added. Thus, in clinical practise a low start inflix
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Contact: EULAR Press Office
eularpressoffice@cohnwolfe.com
44-078-801-73209
European League Against Rheumatism
Source:Eurekalert

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