Secukinumab without the initial loading dose in the treatment of plaque‐type psoriasis – a simplified dosing regimen at the expense of efficacy?

Abstract

Linked Article: Gisondi et al. Br J Dermatol 2020; 182:175–179.

Dermatologic inflammatory conditions require high loading and maintenance doses of biologic therapy

“…1 Despite widespread use, there is limited evaluation of whether drug regimens with loading doses yield better clinical outcomes compared with nonloading dose regimens, especially given their increased cost and resulting pressure on physicians from payors to forego them. [2][3][4] Published reasons for loading dose use include the need for more drug to achieve than maintain disease control, to neutralize or prevent the formation of anti-drug antibodies and to achieve therapeutic drug levels in protein-losing enteropathies, like Crohn's disease and ulcerative colitis. 1,5,6 However, there is no clear pattern of biologic therapy use, as regimens with loading doses are recommended for some biologics but not others, sometimes independent of half-life and drug.…”