BIOLOPTIM-TIL: Therapeutic Drug Monitoring of Tildrakizumab in Psoriasis Patients
Study Details
Study Description
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.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Phase 4 |
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.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Standard of care - tildrakizumab Patients will continue to receive tildrakizumab according to the standard dosing schedule: subcutaneous injections at weeks 0 and 4, then every 12 weeks (100mg) |
Procedure: Venapuncture
Blood samples will be collected to determine the serum trough levels and anti-drug antibodies of tildrakizumab.
Procedure: Patient questionnaires
The study participants will complete the Dermatology Quality of Life (DLQI) and EQ-5D-5L questionnaire at each study visit.
|
Outcome Measures
Primary Outcome Measures
- 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.
- 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).
Secondary Outcome Measures
- 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-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.
- 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.
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Participants must have a clinical or histological diagnosis of chronic plaque-type psoriasis
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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
Exclusion Criteria:
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Participants who have currently a predominant nonplaque form of psoriasis
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Participants who are pregnant, nursing or planning a pregnancy
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Participants who are unable or unwilling to undergo multiple venapunctures
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Participants who are treated according to a different dosing schedule than standard dosing of tildrakizumab
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | University Hospital Ghent | Ghent | East-Flanders | Belgium | 9000 |
| 2 | University Hospital Ghent | Ghent | Belgium | 9000 |
Sponsors and Collaborators
- University Hospital, Ghent
Investigators
- Principal Investigator: Jo Lambert, Prof, University Ghent
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- BIOLOPTIM-TIL