148 Increasing to weekly adalimumab dosing leads to improved psoriasis outcomes-a retrospective single centre review of real-world data

Adalimumab is a well-tolerated and effective biologic treatment for psoriasis. Given its efficacy biosimilar availability, it often first-line biologic. Clinical trial data have demonstrated that dose escalation from fortnightly to weekly an safe strategy. However, real-world lacking; therefore we aimed assess patient response in the clinical setting. We reviewed records of patients treated with adalimumab between January 2018-May 2022. Criteria inclusion were prescribed three months prior escalation, PASI (Psoriasis Area Severity Index) DLQI (Dermatology Life Quality scores recorded at (baseline) 3 or 6-months. 45/72 met criteria. Male female ratio was 22:23 mean age 51.6 years. (Amgevita) first agent 84% (38/45). Baseline 9.2 (SD 6.3) 12.1 7.6), respectively. At months, 62% (10/26) had improved DLQI, 38% achieving 50 15% 75 versus baseline. This improvement sustained 6 months. 45%(13/29) achieved 21% (6/29) 75. 16/45 switched alternative 3/45 methotrexate added point collection. 70% (23/33) measured levels subtherapeutic (<5 μg/ml). 12 baseline 3-6 6/12 increased level (mean increase 2.6μg/ml, SD 4.4) reflected 5/6. 5/33 antibodies escalation. Surprisingly, 2/5 experienced improvement, without level. 4/12 undetectable on both occasions, all which antibodies. In conclusion, demonstrates strategy when standard dosing ineffective, co-existing potential economic benefit switching.