Ixekizumab trough concentrations in psoriasis: Paving the way towards personalised therapy: A cohort study

Abstract Background Biologics for psoriasis demonstrate varying clinical outcome in real‐world practice, implying potential under‐ and overexposure. Objectives In this prospective cohort study we aimed to develop and validate an in‐house sandwich‐type enzyme‐linked immunosorbent assay (ELISA) for ix...

Full description

Saved in:
Bibliographic Details
Main Authors: Lisa Schots, Rani Soenen, Debby Thomas, Annelies Stockman, Erwin Dreesen, Anke Eylenbosch, Jo Lambert
Format: Article
Language:English
Published: Wiley 2024-12-01
Series:JEADV Clinical Practice
Subjects:
Online Access:https://doi.org/10.1002/jvc2.491
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1846143438461861888
author Lisa Schots
Rani Soenen
Debby Thomas
Annelies Stockman
Erwin Dreesen
Anke Eylenbosch
Jo Lambert
author_facet Lisa Schots
Rani Soenen
Debby Thomas
Annelies Stockman
Erwin Dreesen
Anke Eylenbosch
Jo Lambert
author_sort Lisa Schots
collection DOAJ
description Abstract Background Biologics for psoriasis demonstrate varying clinical outcome in real‐world practice, implying potential under‐ and overexposure. Objectives In this prospective cohort study we aimed to develop and validate an in‐house sandwich‐type enzyme‐linked immunosorbent assay (ELISA) for ixekizumab (IXE), and to explore whether there is an exposure‐response relationship in standard maintenance dose for IXE, and whether patient factors influence IXE exposure and clinical outcome. Methods This was a prospective, multicentric, cohort study in psoriasis patients treated with IXE according to standard dosing regimen (BIOLOPTIM‐IXE). IXE trough concentrations (TCs) in sera collected at multiple timepoints were measured using an in‐house immunoassay. Results Using MA‐IXE117E12 and MA‐IXE100F5‐biotin as the capture and detection antibodies, respectively, an ELISA was developed with an exposure‐response curve ranging from 10 to 0.16525 ng/mL. One hundred‐fifteen steady‐state serum samples from 48 patients (17 [35.4%] bio‐experienced; median body weight, 81.5 kg) were measured. Optimal responders (Psoriasis Area and Severity Index [PASI] ≤ 2) had significantly higher TCs than suboptimal responders (PASI > 2) (median TCs, 4.4 and 3.0 μg/mL, respectively; p = 0.026). Median cohort IXE TC was 4.1 µg/mL [2.8−6.1]. An optimal steady‐state IXE TC of 3.4 µg/mL was identified for clinical outcome defined by absolute PASI. Median TCs and absolute PASI were significantly lower and worse, respectively, in patients ≥ 90 kg (p < 0.001 and p = 0.013, respectively) and in bio‐experienced subjects (p < 0.001 and p = 0.029, respectively). Conclusions This study identified an IXE exposure‐response relationship and an optimal effective steady‐state TC of 3.4 µg/mL in real‐world psoriasis patients, revealing the potential of therapeutic drug monitoring in optimising IXE use.
format Article
id doaj-art-80b4775c88c24cff903c09ce92b9927f
institution Kabale University
issn 2768-6566
language English
publishDate 2024-12-01
publisher Wiley
record_format Article
series JEADV Clinical Practice
spelling doaj-art-80b4775c88c24cff903c09ce92b9927f2024-12-02T13:08:37ZengWileyJEADV Clinical Practice2768-65662024-12-01351499150810.1002/jvc2.491Ixekizumab trough concentrations in psoriasis: Paving the way towards personalised therapy: A cohort studyLisa Schots0Rani Soenen1Debby Thomas2Annelies Stockman3Erwin Dreesen4Anke Eylenbosch5Jo Lambert6Department of Dermatology Ghent University Hospital Ghent BelgiumDepartment of Dermatology Ghent University Hospital Ghent BelgiumDepartment of Pharmaceutical and Pharmacological Sciences KU Leuven Leuven BelgiumDepartment of Dermatology AZ Delta Torhout BelgiumDepartment of Pharmaceutical and Pharmacological Sciences KU Leuven Leuven BelgiumDepartment of Dermatology Ghent University Hospital Ghent BelgiumDepartment of Dermatology Ghent University Hospital Ghent BelgiumAbstract Background Biologics for psoriasis demonstrate varying clinical outcome in real‐world practice, implying potential under‐ and overexposure. Objectives In this prospective cohort study we aimed to develop and validate an in‐house sandwich‐type enzyme‐linked immunosorbent assay (ELISA) for ixekizumab (IXE), and to explore whether there is an exposure‐response relationship in standard maintenance dose for IXE, and whether patient factors influence IXE exposure and clinical outcome. Methods This was a prospective, multicentric, cohort study in psoriasis patients treated with IXE according to standard dosing regimen (BIOLOPTIM‐IXE). IXE trough concentrations (TCs) in sera collected at multiple timepoints were measured using an in‐house immunoassay. Results Using MA‐IXE117E12 and MA‐IXE100F5‐biotin as the capture and detection antibodies, respectively, an ELISA was developed with an exposure‐response curve ranging from 10 to 0.16525 ng/mL. One hundred‐fifteen steady‐state serum samples from 48 patients (17 [35.4%] bio‐experienced; median body weight, 81.5 kg) were measured. Optimal responders (Psoriasis Area and Severity Index [PASI] ≤ 2) had significantly higher TCs than suboptimal responders (PASI > 2) (median TCs, 4.4 and 3.0 μg/mL, respectively; p = 0.026). Median cohort IXE TC was 4.1 µg/mL [2.8−6.1]. An optimal steady‐state IXE TC of 3.4 µg/mL was identified for clinical outcome defined by absolute PASI. Median TCs and absolute PASI were significantly lower and worse, respectively, in patients ≥ 90 kg (p < 0.001 and p = 0.013, respectively) and in bio‐experienced subjects (p < 0.001 and p = 0.029, respectively). Conclusions This study identified an IXE exposure‐response relationship and an optimal effective steady‐state TC of 3.4 µg/mL in real‐world psoriasis patients, revealing the potential of therapeutic drug monitoring in optimising IXE use.https://doi.org/10.1002/jvc2.491Ixekizumabpsoriasistherapeutic drug monitoringtrough concentrations
spellingShingle Lisa Schots
Rani Soenen
Debby Thomas
Annelies Stockman
Erwin Dreesen
Anke Eylenbosch
Jo Lambert
Ixekizumab trough concentrations in psoriasis: Paving the way towards personalised therapy: A cohort study
JEADV Clinical Practice
Ixekizumab
psoriasis
therapeutic drug monitoring
trough concentrations
title Ixekizumab trough concentrations in psoriasis: Paving the way towards personalised therapy: A cohort study
title_full Ixekizumab trough concentrations in psoriasis: Paving the way towards personalised therapy: A cohort study
title_fullStr Ixekizumab trough concentrations in psoriasis: Paving the way towards personalised therapy: A cohort study
title_full_unstemmed Ixekizumab trough concentrations in psoriasis: Paving the way towards personalised therapy: A cohort study
title_short Ixekizumab trough concentrations in psoriasis: Paving the way towards personalised therapy: A cohort study
title_sort ixekizumab trough concentrations in psoriasis paving the way towards personalised therapy a cohort study
topic Ixekizumab
psoriasis
therapeutic drug monitoring
trough concentrations
url https://doi.org/10.1002/jvc2.491
work_keys_str_mv AT lisaschots ixekizumabtroughconcentrationsinpsoriasispavingthewaytowardspersonalisedtherapyacohortstudy
AT ranisoenen ixekizumabtroughconcentrationsinpsoriasispavingthewaytowardspersonalisedtherapyacohortstudy
AT debbythomas ixekizumabtroughconcentrationsinpsoriasispavingthewaytowardspersonalisedtherapyacohortstudy
AT anneliesstockman ixekizumabtroughconcentrationsinpsoriasispavingthewaytowardspersonalisedtherapyacohortstudy
AT erwindreesen ixekizumabtroughconcentrationsinpsoriasispavingthewaytowardspersonalisedtherapyacohortstudy
AT ankeeylenbosch ixekizumabtroughconcentrationsinpsoriasispavingthewaytowardspersonalisedtherapyacohortstudy
AT jolambert ixekizumabtroughconcentrationsinpsoriasispavingthewaytowardspersonalisedtherapyacohortstudy