{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:28:50Z","timestamp":1790702930085,"version":"4.1.0"},"reference-count":14,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,8,13]],"date-time":"2022-08-13T00:00:00Z","timestamp":1660348800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>Dose spacing (DS) can be useful for optimizing treatment with biologics in psoriasis patients. However, interval prolongation might increase the production of anti-drug antibodies (ADA) and, therefore, reduce the drug\u2019s effectiveness. The long-term effects of DS with adalimumab in psoriatic patients have not been reported. The goal of our study was to evaluate the long-term follow-up of psoriatic patients after adalimumab DS regarding the clinical course and determination of circulating adalimumab, TNF\u03b1 levels, and anti-adalimumab antibodies. We retrospectively included seven patients treated with adalimumab for moderate-to-severe psoriasis and benefiting from DS from 2010 to 2021. The dose interval of adalimumab was extended to three weeks for all patients and then to four weeks for three of the seven patients. Adalimumab trough levels, TNF\u03b1 levels, and ADA against adalimumab were measured. For six of the seven patients, absolute PASI values remained below 3 throughout the follow-up period (median = 8.0 years; range: 1.7\u201311.5) after DS. All the patients were satisfied with the effectiveness of their treatment regime. Within the follow-up period, an average of 63 doses of adalimumab per patient were spared. The median adalimumab trough levels were 4.7 \u00b5g\/mL (range: 1.9\u201312.5). TNF\u03b1 levels remained under 10 pg\/mL (undetectable) in all except one patient. ADA against adalimumab remained negative (&lt;10 \u00b5g\/mL) during the follow-up in all patients. Our data indicate that therapeutic drug monitoring, including the measurement of trough concentrations and ADA, together with the clinical response and patient\u2019s preference, can be helpful for clinical decision making and treatment optimization in psoriasis.<\/jats:p>","DOI":"10.3390\/bioengineering9080387","type":"journal-article","created":{"date-parts":[[2022,8,14]],"date-time":"2022-08-14T21:09:06Z","timestamp":1660511346000},"page":"387","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Long-Term Dose Optimization of Adalimumab via Dose Spacing in Patients with Psoriasis"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3584-0304","authenticated-orcid":false,"given":"Michael","family":"Benzaquen","sequence":"first","affiliation":[{"name":"Department of Dermatology, Inselspital-Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Munshi","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Inselspital-Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Bossart","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Inselspital-Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4858-5525","authenticated-orcid":false,"given":"Laurence","family":"Feldmeyer","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Inselspital-Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vladimir","family":"Emelianov","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Inselspital-Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0024-338X","authenticated-orcid":false,"given":"Nikhil","family":"Yawalkar","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Inselspital-Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8161-6138","authenticated-orcid":false,"given":"Simone","family":"Cazzaniga","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Inselspital-Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland"},{"name":"Centro Studi GISED, 24128 Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9217-6086","authenticated-orcid":false,"given":"Kristine","family":"Heidemeyer","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Inselspital-Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1111\/jdv.14145","article-title":"Dose adjustment of biologic therapies for psoriasis in dermatological practice: A retrospective study","volume":"31","author":"Esposito","year":"2017","journal-title":"J. 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Dermatol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1155\/MI.2005.273","article-title":"Serum levels of TNF-alpha, IFN-gamma, IL-6, IL-8, IL-12, IL-17, and IL-18 in patients with active psoriasis and correlation with disease severity","volume":"2005","author":"Arican","year":"2005","journal-title":"Mediat. Inflamm."}],"container-title":["Bioengineering"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2306-5354\/9\/8\/387\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:08:24Z","timestamp":1760141304000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2306-5354\/9\/8\/387"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,13]]},"references-count":14,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,8]]}},"alternative-id":["bioengineering9080387"],"URL":"https:\/\/doi.org\/10.3390\/bioengineering9080387","relation":{},"ISSN":["2306-5354"],"issn-type":[{"value":"2306-5354","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,13]]}}}