Dosage Adjustments in Patients With Psoriasis on Etanercept: A Retrospective Chart Review

Etanercept, 1 of 11 Food and Drug Administration (FDA)–approved biologics used for the treatment for psoriasis, may often be used at off-label dosages. The aim of this retrospective chart review was to determine the frequency of off-label dosing in a single center and the reasons for these deviations as well as the outcomes. The results of this study demonstrated that nearly two-thirds (64.7%) of patients treated with etanercept had some form of dosage adjustment during their treatment course. Dosage increases were reported most often; all were due to inefficacy of etanercept at the FDA-approved dosing. Interruptions and decreased dosages were reported among 36.4% and 18.2% of patients, respectively. Our study confirms previous data suggesting use of off-label doses of etanercept is commonplace, and a trial of increased etanercept dosing may be worthwhile for biologic-naive patients achieving suboptimal clinical response on standard dosing before switching to another biologic.