Related Experiment Videos
Dose Reduction of IL17 and IL23 Inhibitors in Psoriasis (BeNeBio study): An International, Pragmatic, Multicentre,
Juul M P A van den Reek1, Charlotte A M van Riel1, Rani Soenen2
1Department of Dermatology, Radboud University Medical Centre, Nijmegen, the Netherlands.
The Lancet Regional Health. Europe
|August 11, 2026
Summary
Reducing doses of Interleukin (IL)17 and IL23 inhibitors for psoriasis is effective and safe. Stepwise dose reduction in patients with stable low disease activity prevents unnecessary drug exposure.
Area of Science:
- Dermatology
- Immunology
- Pharmacology
Background:
- Interleukin (IL)17 and IL23 inhibitors are effective psoriasis treatments.
- Not all patients require the registered dose, suggesting potential for dose reduction (DR).
- DR can minimize drug exposure and healthcare costs.
Purpose of the Study:
- To assess the efficacy and safety of stepwise dose reduction (DR) via interval prolongation.
- To evaluate DR in patients with psoriasis and stable low disease activity.
Main Methods:
- A pragmatic, open-label, controlled, non-inferiority randomized clinical trial involving 19 hospitals.
- Patients with stable low disease activity on IL17i or IL23i were randomized (2:1) to stepwise DR or usual care (UC).
- Injection intervals were stepwise prolonged in the DR group; primary endpoint was persistent flares after 18 months.
Main Results:
- 244 patients were included (DR N=164, UC N=80).
- After 18 months, the incidence proportion of persistent flares was 4.0% in the DR group and 1.6% in the UC group (ITT analysis).
- The DR strategy demonstrated non-inferiority to UC, with no serious adverse events related to DR.
Conclusions:
- Disease-activity guided, stepwise interval prolongation of IL17i and IL23i is effective and safe.
- This strategy reduces unnecessary exposure to expensive biologic drugs in patients with controlled psoriasis.
- Dose reduction offers a viable approach for managing psoriasis treatment costs and patient burden.
Related Concept Videos
01:24T Cell Types and Functions
When T cells with CD4 markers are activated, they give rise to two types of effector cells: helper T cells and regulatory T cells. Meanwhile, T cells with CD8 markers differentiate into effector cytotoxic T cells. The differentiation of CD4 T cells into helper T cell subsets, such as Th1, Th2, and Th17 cells, is dependent on the antigen type, antigen-presenting cell, and regulatory cytokines.
Th1 cells stimulate dendritic cells to express necessary co-stimulatory molecules on their surfaces for...
Th1 cells stimulate dendritic cells to express necessary co-stimulatory molecules on their surfaces for...
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel Disease...