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A total of 543 patients on adalimumab monotherapy for psoriasis provided 946 pharmacokinetic samples and 1700 Psoriasis Area Severity Index (PASI) disease severity measurements. To describe the PASI change over time, a one\u2010compartment linear PK model with first\u2010order absorption and elimination was linked to a turnover mechanism of skin lesions. Based on the PKPD relationship and a predefined therapeutic range, real\u2010time stochastic simulation was performed for a proactive TDM strategy, where trough levels guided dose escalation or reduction. Compared to the standard care, the TDM strategy improved PASI90 and PASI75 by 37.5% and 12.8%, respectively, with a 25.9% increase in drug costs. In the future, incorporating the PKPD model into a Bayesian therapeutic monitoring algorithm could facilitate individualized adalimumab dosing.<\/jats:p>","DOI":"10.1111\/cts.70563","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T07:17:21Z","timestamp":1777533441000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of a Therapeutic Drug Monitoring Strategy for Adalimumab in Psoriasis: A Prospective Pharmacokinetic\u2010Pharmacodynamic Study"],"prefix":"10.1111","volume":"19","author":[{"given":"Shan","family":"Pan","sequence":"first","affiliation":[{"name":"St John's Institute of Dermatology Guy's and St Thomas' NHS Foundation Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1895-6070","authenticated-orcid":false,"given":"Teresa","family":"Tsakok","sequence":"additional","affiliation":[{"name":"St John's Institute of Dermatology Guy's and St Thomas' NHS Foundation Trust  London UK"},{"name":"St John's Institute of Dermatology, School of Basic &amp; 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