Dermatologists on the medical need for therapeutic drug monitoring of biologics in psoriasis: results of a structured survey

Abstract

Background

Therapeutic drug monitoring (TDM) may lead to more rational use of biologics. Still, TDM is largely underexplored in psoriasis. Little is known about the dosing behavior of biologics by dermatologists, and their attitude toward TDM.

Objective

Exploration of the awareness and need for the concept of TDM in psoriasis amongst (inter)national dermatologists.

Method

A survey was distributed at the Belgian Dermatology Days 2019 and Skin Inflammation & Psoriasis International Network (SPIN) Congress 2019. Next, an online survey version was launched amongst the SPIN Scientific Committee members. We collected physician’s characteristics, prescription behavior of biologics, data regarding clinical response to biologics and attitude toward TDM.

Results

A total of 107 surveys were included for analysis. Most dermatologists were Belgium-based (54.2%), others from European (23.4%) or non-European countries (19.6%). Seventy percent performed either dose increase (64.8%), time interval shortening (74.6%), dose lowering (16.9%) or time interval extension (33.8%). The majority who performed dose adaptations acknowledged the need for TDM.

Conclusion

This study showed most dermatologists perform dose adaptations empirically. The need for TDM was indicated by the majority, implying the need for effective communication regarding availability, utility and implementation of TDM assays in daily dermatology practice.

Keywords:

• Biologics
• drug concentration
• psoriasis
• questionnaire
• therapeutic drug monitoring

Acknowledgements

The authors express their gratitude to the participants for taking time out and share their experiences. All authors approved the final version of the manuscript.

Disclosure statement

The authors report no conflict of interest.

Notes

1 The latter question was only incorporated in the survey completed by the ED.

Additional information

Funding

This work was supported by the Fonds Wetenschappelijk Onderzoek (FWO) under Grant [FWO-TBM T003218N].