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

Abstract

AbstractBackgroundBiological therapy dose modification is a common practice in the long‐term treatment of plaque psoriasis.ObjectiveThe 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.MethodsA retrospective, observational, multicenter cohort study was conducted in patients with plaque psoriasis treated with secukinumab and up to 2 years of follow‐up.ResultsIn 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.LimitationsThe proper of the study designed and the arbitrary definition of “DR success.”ConclusionOff‐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.