Using Real‐World Data to Guide Ustekinumab Dosing Strategies for Psoriasis: A Prospective Pharmacokinetic‐Pharmacodynamic Study

• DOI: 10.1111/cts.12725
• Publication Date: 2020-01-29T18:39:06Z
• Authors: Shan Pan; Teresa Tsakok; Nick Dand; Dagan O. Lonsdale; Floris C. Loeff; Karien Bloem; Annick de Vries; David Baudry; Michael Duckworth; Satveer Mahil; Angela Pushpa‐Rajah; Alice Russell; Ali Alsharqi; Gabrielle Becher; Ruth Murphy; Shyamal Wahie; Andrew Wright; Christopher E.M. ...; Nick J. Reynolds; Jonathan Barker; Richard B. Warren; A. David Burden; Theo Rispens; Joseph F. Standing; Catherine H. Smith
• Keywords: Ustekinumab; Pharmacodynamics; Therapeutic Drug Monitoring; Body surface area

Variation in response to biologic therapy for inflammatory diseases, such as psoriasis, is partly driven by variation drug exposure. Real‐world psoriasis data were used develop a pharmacokinetic/pharmacodynamic (PK/PD) model the first‐line therapeutic antibody ustekinumab. The impact of differing dosing strategies on was explored. Data collected from UK prospective multicenter observational cohort (491 patients ustekinumab monotherapy, levels, and anti‐drug measurements 797 serum samples, 1,590 Psoriasis Area Severity Index (PASI)). Ustekinumab PKs described with linear one‐compartment model. A maximum effect (E max ) inhibited progression psoriatic skin lesions turnover PD mechanism describing PASI evolution while treatment. mixture half‐maximal effective concentration identified potential nonresponder group, simulations suggesting that, future, could be incorporated into Bayesian monitoring “dashboard” individualize improve treatment outcomes.