Volume 63, Issue 4 pp. 503-511
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Dose reduction is a feasible strategy in patients with plaque psoriasis who achieve sustained response with secukinumab: a retrospective, multicenter cohort study in daily practice setting

Esteban Daudén MD, PhD

Esteban Daudén MD, PhD

Hospital Universitario de la Princesa. Instituto de Investigación Sanitaria la Princesa (IIS-IP), Madrid, Spain

Both co-authors contributed equally to this study.

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Elena Escario MD

Elena Escario MD

Hospital Universitario de la Princesa. Instituto de Investigación Sanitaria la Princesa (IIS-IP), Madrid, Spain

Both co-authors contributed equally to this study.

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Luisa Martos-Cabrera MD

Corresponding Author

Luisa Martos-Cabrera MD

Hospital Universitario de la Princesa. Instituto de Investigación Sanitaria la Princesa (IIS-IP), Madrid, Spain

Both co-authors contributed equally to this study.

Correspondence

Luisa Martos-Cabrera, MD

Hospital Universitario de la Princesa

Calle Diego de León, 62

Madrid 28006

Spain

E-mail: [email protected]

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Susana Armesto MD

Susana Armesto MD

Hospital Universitario Marqués de Valdecilla, Santander, Spain

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Enrique Herrera-Acosta MD

Enrique Herrera-Acosta MD

Hospital Virgen de la Victoria, Málaga, Spain

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David Vidal MD

David Vidal MD

Hospital de Sant Joan Despí Moisés Broggi, Barcelona, Spain

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Eva Vilarrasa MD

Eva Vilarrasa MD

Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

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Raquel Rivera MD

Raquel Rivera MD

Hospital Universitario 12 de Octubre, Madrid, Spain

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Pablo de la Cueva MD, PhD

Pablo de la Cueva MD, PhD

Hospital Universitario Infanta Leonor, Madrid, Spain

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Antonio Martorell MD, PhD

Antonio Martorell MD, PhD

Hospital de Manises, Valencia, Spain

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Ferran Ballesca MD

Ferran Ballesca MD

Hospital Universitario Germans Trias i Pujol, Barcelona, Spain

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Isabel Belinchón MD

Isabel Belinchón MD

Hospital General Universitario de Alicante – ISABIAL, Alicante, Spain

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Gregorio Carretero MD

Gregorio Carretero MD

Hospital Universitario Doctor Negrín, Las Palmas de Gran Canaria, Spain

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Lourdes Rodríguez MD

Lourdes Rodríguez MD

Hospital Universitario Virgen del Rocío, Sevilla, Spain

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Alberto Romero-Maté MD

Alberto Romero-Maté MD

Hospital de Fuenlabrada, Madrid, Spain

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J. Pujol-Montcusí MD

J. Pujol-Montcusí MD

Hospital Universitario de Tarragona "Joan XXIII", Tarragona, Spain

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Laura Salgado MD

Laura Salgado MD

Complejo Hospitalario Universitario, Pontevedra, Spain

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Antonio Sahuquillo-Torralba MD

Antonio Sahuquillo-Torralba MD

Hospital Universitario y Politécnico La Fe, Instituto de Investigación Sanitaria La Fe, Valencia, Spain

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Pablo Coto-Segura MD

Pablo Coto-Segura MD

Hospital Vital Alvarez-Buylla de Mieres, Asturias, Spain

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Ofelia Baniandrés MD

Ofelia Baniandrés MD

Hospital General Universitario Gregorio Marañón, Madrid, Spain

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R. Feltes MD

R. Feltes MD

Hospital Universitario la Paz, Madrid, Spain

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Josep Riera-Monroig MD

Josep Riera-Monroig MD

Hospital Clínic i Provincial, Barcelona, Spain

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Jesus Garrido MD

Jesus Garrido MD

Universidad Autónoma de Madrid, Madrid, Spain

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Mar Llamas-Velasco MD, PhD

Mar Llamas-Velasco MD, PhD

Hospital Universitario de la Princesa. Instituto de Investigación Sanitaria la Princesa (IIS-IP), Madrid, Spain

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First published: 02 January 2024

Funding source: None.

Abstract

Background

Biological therapy dose modification is a common practice in the long-term treatment of plaque psoriasis.

Objective

The objective of the study was to determine prevalence, characteristics of patients, effectiveness, treatment survival of secukinumab dose reduction (SEC-DR) strategy and assess its safety and cost implications.

Methods

A retrospective, observational, multicenter cohort study was conducted in patients with plaque psoriasis treated with secukinumab and up to 2 years of follow-up.

Results

In 63/347 patients with an initial standard dose regimen, SEC-DR was tried at any moment in 18.2% of them after sustained response. In 51 patients, the interval between administrations was increased while in 12 patients, monthly dose was reduced to 150 mg. Successful SEC-DR was achieved in 77.8% of the patients, with sustained PASI response to the end of the study. Survival of secukinumab treatment and safety profile were not compromised by DR. The use of DR saved 33% of the cost, including failures in which standard treatment was resumed.

Limitations

The proper of the study designed and the arbitrary definition of “DR success.”

Conclusion

Off-label SEC-DR strategy was used in patients with sustained response to standard dose regimen; this strategy showed long-term efficacy without compromising treatment survival or worsening the safety profile while also being cost saving.

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