Department of Dermatology, Ghent University Hospital, Ghent, Belgium.
Department of Head and Skin, Ghent University, Ghent, Belgium.
J Dermatolog Treat. 2022 May;33(3):1473-1481. doi: 10.1080/09546634.2020.1832649. Epub 2020 Oct 15.
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.
Exploration of the awareness and need for the concept of TDM in psoriasis amongst (inter)national dermatologists.
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.
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.
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.
治疗药物监测(TDM)可能会导致生物制剂的使用更加合理。然而,在银屑病中,TDM 仍在很大程度上未得到充分探索。皮肤科医生对生物制剂的剂量行为及其对 TDM 的态度知之甚少。
探索(国际)皮肤科医生对银屑病 TDM 概念的认识和需求。
在 2019 年比利时皮肤病日和皮肤炎症与银屑病国际网络(SPIN)大会上分发了一份调查。然后,在 SPIN 科学委员会成员中推出了在线调查版本。我们收集了医生的特征、生物制剂的处方行为、生物制剂临床反应的数据以及对 TDM 的态度。
共纳入 107 份调查进行分析。大多数皮肤科医生来自比利时(54.2%),其他来自欧洲(23.4%)或非欧洲国家(19.6%)。70%的医生进行了剂量增加(64.8%)、时间间隔缩短(74.6%)、剂量降低(16.9%)或时间间隔延长(33.8%)。大多数进行剂量调整的医生承认需要 TDM。
本研究表明,大多数皮肤科医生凭经验进行剂量调整。大多数人表示需要 TDM,这意味着需要就 TDM 检测在日常皮肤科实践中的可用性、实用性和实施进行有效的沟通。