Therapeutic Drug Monitoring of Tildrakizumab in Psoriasis Patients
- Conditions
- Psoriasis Vulgaris
- Interventions
- Procedure: VenapunctureProcedure: Patient questionnaires
- Registration Number
- NCT05683015
- Lead Sponsor
- University Hospital, Ghent
- Brief Summary
Biologics such as tildrakizumab 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, the investigators aim to investigate the predictive value of early serum trough levels of tildrakizumab and determine the therapeutic window of tildrakizumab in psoriasis patients.
- Detailed Description
Patients will be included after signing informed consent. After inclusion, patients will continue on standard dosing schedule of tildrakizumab (i.e. subcutaneous injections at weeks 0 and 4, then every 12 weeks (100mg)). During each study visit blood will be taken in order to quantify Ctroughs and/or anti-drug antibodies towards tildrakizumab. 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
- RECRUITING
- Sex
- All
- Target Recruitment
- 100
- 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 tildrakizumab
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Standard of care - tildrakizumab Venapuncture Patients will continue to receive tildrakizumab according to the standard dosing schedule: subcutaneous injections at weeks 0 and 4, then every 12 weeks (100mg) Standard of care - tildrakizumab Patient questionnaires Patients will continue to receive tildrakizumab according to the standard dosing schedule: subcutaneous injections at weeks 0 and 4, then every 12 weeks (100mg)
- Primary Outcome Measures
Name Time Method Development of the therapeutic window of tildrakizumab in psoriasis Week 0 until week 52 of treatment Defining a therapeutic window for tildrakizumab based on serum trough concentrations corresponding with adequate clinical response (ROC analysis and concentration-effect curve).
Correlation between early serum trough concentrations of tildrakizumab and clinical response Week 0 until week 24 of treatment To assess the predictive value of early serum trough levels of tildrakizumab (µg/ml), the clinical response (PASI) at week 12 and/or week 24 will be correlated with serum trough concentrations of tildrakizumab measurements taken from week 0,1,2,3 and/or 4.
Predictive value of early anti-drug antibodies of tildrakizumab Week 0 until week 24 of treatment To assess the predictive value of early anti-drug antibodies of tildrakizumab (µg/ml), the clinical response (PASI) at week 12 and/or week 24 will be correlated with serum trough concentrations of tildrakizumab measurements taken from week 0,1,2,3 and/or 4.
- Secondary Outcome Measures
Name Time Method 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.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.
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 of the five dimensions can be combined into a 5- digit number that describes the patients' health state.
Trial Locations
- Locations (1)
University Hospital Ghent
🇧🇪Ghent, Belgium