Therapeutic Drug Monitoring of Guselkumab in Psoriasis Patients
- Conditions
- Psoriasis Vulgaris
- Interventions
- Procedure: VenapunctureOther: Patient questionnaires
- Registration Number
- NCT04080648
- Lead Sponsor
- University Hospital, Ghent
- Brief Summary
Biologic such as guselkumab 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 guselkumab and determine the therapeutic window of guselkumab in psoriasis patients.
- Detailed Description
Patients will be included after signing informed consent. After inclusion, patients will continue on standard dosing schedule of guselkumab (i.e. one loading dose (100 mg) at week 0 and week 4 and followed by subcutaenously injections every 8 weeks). During each study visit blood will be taken in order to quantify Ctroughs and/or anti-drug antibodies towards guselkumab. 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
- 79
- Participants must have a clinical or histological diagnosis of chronic plaque-type psoriasis
- 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
- Participants who have currently a predominant nonplaque form of psoriasis
- Participants who are pregnant, nursing or planning a pregnancy
- Participants who are unable or unwilling to undergo multiple venapunctures
- Participants who are treated according to a different dosing schedule than standard dosing of guselkumab
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Standard of case - guselkumab Venapuncture Patients will continue to receive guselkumab according to the standard dosing schedule; subcutaneous injection of 100 mg at weeks 0 and 4 and then every 8 weeks Standard of case - guselkumab Patient questionnaires Patients will continue to receive guselkumab according to the standard dosing schedule; subcutaneous injection of 100 mg at weeks 0 and 4 and then every 8 weeks
- Primary Outcome Measures
Name Time Method Predictive value of early serum trough concentrations of guselkumab Week 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 guselkumab measurements taken from week 0, 1, 2, 3, and/or 4.
Development of the therapeutic window of guselkumab in psoriasis Week 0 until week 52 of treatment Defining a therapeutic window for guselkumab based on serum trough concentrations corresponding with adequate clinical response
Predictive value of early anti-drug antibodies of guselkumab Week 0 until week 24 of treatment Prediction of the clinical response (PASI) at week 12 and/or week 24 based on anti-drug antibodies of guselkumab measurements taken from week 0, 1, 2, 3, and/or 4.
- Secondary Outcome Measures
Name Time Method EQ-5D-5L Week 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 for the five dimensions can be combined into a 5-digit number that describes the patient's health state.
EQ VAS Week 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.
DLQI Week 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.
Trial Locations
- Locations (7)
University Hospital Ghent
🇧🇪Ghent, East-Flanders, Belgium
AZ Maria Middelares
🇧🇪Ghent, East-Flanders, Belgium
AZ Sint-Lucas
🇧🇪Ghent, East-Flanders, Belgium
Private practice Dermatology
🇧🇪Maldegem, East-Flanders, Belgium
AZ Sint-Jan
🇧🇪Brugge, West-Flanders, Belgium
University Hospital
🇧🇪Leuven, Vlaams-Brabant, Belgium
AZ Delta Rembert
🇧🇪Torhout, West-Flanders, Belgium