Evidence map›Paper›PMID 36867069›Full record

ArticleThe Journal of dermatological treatment2023

Steps towards implementation of protocolized dose reduction of adalimumab, etanercept and ustekinumab for psoriasis in daily practice.

L S van der Schoot, J J Janssen, M T Bastiaens, A de Boer-Brand, C Christiaansen-Smit, D N H Enomoto, R Hovingh, R A Tupker, M M B Seyger, L M Verhoef and 2 more

Open access · diamondFull text read
In one paragraph

Article in The Journal of dermatological treatment, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 5 institutions in 1 country.

L S van der SchootDepartment of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands.ORCID 0000-0002-4127-1187
J J JanssenDepartment of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands.
M T BastiaensDepartment of Dermatology, Elisabeth-TweeSteden Ziekenhuis, Tilburg, The Netherlands.
A de Boer-BrandDepartment of Dermatology, St Antonius Ziekenhuis, Nieuwegein, The Netherlands.
C Christiaansen-SmitDepartment of Dermatology, Elisabeth-TweeSteden Ziekenhuis, Tilburg, The Netherlands.
D N H EnomotoDepartment of Dermatology, Dermatologisch Centrum Isala, Zwolle, The Netherlands.
R HovinghDepartment of Dermatology, Elisabeth-TweeSteden Ziekenhuis, Tilburg, The Netherlands.
R A TupkerDepartment of Dermatology, St Antonius Ziekenhuis, Nieuwegein, The Netherlands.
M M B SeygerDepartment of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands.
L M VerhoefDepartment of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands.
J M P A van den ReekDepartment of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands.
E M G J de JongDepartment of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands.
Radboud University Nijmegen · NLElisabeth-TweeSteden Ziekenhuis · NLSt. Antonius Ziekenhuis · NLIsala · NLSint Maartenskliniek · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDose reduction (DR) of adalimumab, etanercept and ustekinumab has proven to be (cost-)effective in psoriasis patients with low disease activity. Further implementation is needed to establish application of DR for eligible patients.

objectivesTo evaluate the implementation of protocolized biologic DR in daily practice.

methodsA pilot implementation study was performed in 3 hospitals during 6 months. By combining education and protocol development, involved healthcare providers (HCPs) were directed toward the adoption of protocolized DR. DR of adalimumab, etanercept, and ustekinumab was achieved by stepwise injection interval prolongation. Implementation outcomes (fidelity, feasibility) were assessed. Factors for optimizing implementation were explored in interviews with HCPs. Uptake was measured in patients by chart review.

resultsThe implementation strategy was executed as planned. Implementation fidelity was less than 100% as not all provided tools were used across study sites. HCPs indicated the feasibility of implementing protocolized DR, although time investment was needed. Identified additional factors for successful implementation included support for patients, uptake of DR into guidelines, and supportive electronic health record systems. During the 6 months intervention period, 52 patients were eligible for DR of whom 26 (50%) started DR. The proposed DR protocol was followed in 22/26 patients (85%) on DR.

conclusionAdditional staff for support, extra time during consultations, education on DR for HCPs and patients, and effective tools such as a feasible protocol can lead to more patients on biologic DR.

Indexed as

Biological ProductsDermatologic AgentsPsoriasisAdalimumabDrug TaperingEtanerceptHumansUstekinumabAdalimumabBiological ProductsDermatologic AgentsEtanerceptUstekinumabbiologicsdose reductionimplementationPsoriasis

Identifiers

PMID36867069
PMCPMC10013325
OpenAlexW4323037402

What OpenQuestion holds

Textfull text, public
LicenceCC BY
measurements read15
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.