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Therapeutic Drug Monitoring of Secukinumab in Psoriasis Patients.

Phase 4
Completed
Conditions
Psoriasis Vulgaris
Interventions
Procedure: Venapuncture
Other: Patient questionnaires
Registration Number
NCT04080661
Lead Sponsor
University Hospital, Ghent
Brief Summary

Biologics such as secukinumab are currently the most effective treatment option for patients with moderate to severe psoriasis. But they are costly for healthcare systems and still described according to a'one dose fits all' dosing regimen, leading to potential over-and undertreatment. In this study we aim to investigate the predictive value of early serum trough levels of secukinumab and determine the therapeutic window of secukinumab in psoriasis patients.

Detailed Description

Patients will be included after signing informed consent. After inclusion, patients will continue on standard dosing schedule of secukinumab (i.e. subcutaneous injections once a week for 5 weeks (300 mg) followed by subcutaneous injections every 4 weeks). During each study visit blood will be taken in order to quantify Ctroughs and/or anti-drug antibodies towards secukinumab. In addition, Psoriasis Area and Severity Index (PASI) and Investigator's Global Assessment (IGA) score will be evaluated by a physician. Patients complete the Dermatology Life Quality Index (DLQI) and European quality of life EQ-5D instrument at each visit.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
82
Inclusion Criteria
  1. Participants must have a clinical or histological diagnosis of chronic plaque-type psoriasis
  2. Participants must sign an ICF indicating that he or she understands the purpose of, and procedures required for, the study and is willing to participate in the study
Exclusion Criteria
  1. Participants who have currently a predominant nonplaque form of psoriasis
  2. Participants who are pregnant, nursing or planning a pregnancy
  3. Participants who are unable or unwilling to undergo multiple venapunctures
  4. Participants who are treated according to a different dosing schedule than standard dosing of secukinumab

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Standard of care - secukinumabPatient questionnairesPatients will continue to receive secukinumab according to the standard dosing schedule: subcutaneous injections once a week for 5 weeks, then every 4 weeks (300 mg).
Standard of care - secukinumabVenapuncturePatients will continue to receive secukinumab according to the standard dosing schedule: subcutaneous injections once a week for 5 weeks, then every 4 weeks (300 mg).
Primary Outcome Measures
NameTimeMethod
Predictive value of early serum trough concentrations of secukinumabWeek 0 until week 24 of treatment

Prediction of the clinical response (PASI) at week 12 and/or week 24 based on serum trough concentrations of secukinumab measurements taken from week 0,1,2,3 and/or 4.

Predictive value of early anti-drug antibodies of secukinumabWeek 0 until week 24 of treatment

Prediction of the clinical response (PASI) at week 12 and/or week 24 based on anti-drug antibodies (ADA) measurements taken from week 0,1,2,3 and/or 4.

Development of the therapeutic window of secukinumab in psoriasisWeek 0 until week 52 of treatment

Defining a therapeutic window for secukinumab based on serum trough concentrations corresponding with adequate clinical response

Secondary Outcome Measures
NameTimeMethod
EQ-5D-5LWeek 0 until week 52 of treatment

The EQ-5D-5L comprises five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems and extreme problems.The patient is asked to indicate his/her health state by ticking the box next to the most appropriate statement in each of the five dimensions. This decision results in a 1-digit number that expresses the level selected for that dimension. The digits of the five dimensions can be combined into a 5- digit number that describes the patients' health state.

DLQIWeek 0 until week 52 of treatment

The DLQI (Dermatology Life Quality Index) (range 0-30) is a dermatology specific quality of life (QoL) instrument designed to assess the impact of the disease on participant's QoL. It is a ten item questionnaire that, in addition to evaluated overall QoL, can be used to assess six different aspects that may affect QoL: 1) symptoms and feelings, 2) daily activities, 3) leasure, 4) work or school performances, 5) personal relationships, and 6) treatment.

The scoring of each question is as follows:

Very much - scored 3; A lot - scored 2; A little - scored 1; Not at all - scored 0; Not relevant - scored 0; Question 7, 'prevented work or studying' - scored 3. The DLQI is calculated by summing the score of each question resulting in a maximum of 30 and a minimum of 0. The higher the score, the more quality of life is impaired.

EQ VASWeek 0 until week 52 of treatment

The EQ VAS (Visual Analogue Scale) (range 0-10) records the patient's self-rated health on a vertical visual analogue scale, where the endpoints are labelled 'The best health you can imagine' and 'The worst health you can imagine'. The VAS can be used as a quantitative measure of health outcome that reflect the patient's own judgement.

Trial Locations

Locations (7)

AZ Sint-Lucas

🇧🇪

Ghent, East-Flanders, Belgium

AZ Sint-Jan

🇧🇪

Brugge, West-Flanders, Belgium

AZ Delta Rembert

🇧🇪

Torhout, West-Flanders, Belgium

Private practice Dermatology

🇧🇪

Maldegem, East-Flanders, Belgium

University Hospital Ghent

🇧🇪

Ghent, East-Flanders, Belgium

University Hospital Leuven

🇧🇪

Leuven, Vlaams-Brabant, Belgium

AZ Maria Middelares

🇧🇪

Ghent, East-Flanders, Belgium

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