The authors suggest that their results can be used to develop a therapeutic algorithm for adalimumab treatment for chronic plaque-type psoriasis, in which the dosing schedule can be adjusted according to serum trough levels of adalimumab and anti-drug antibodies. As one third of patients in the study had levels above the identified upper margin, they suggest that the more rationale use of biological therapy in psoriasis could potentially lead to cost savings.
Limitations of the study include lack of information on patients using concomitant methotrexate, PASI assessments in individual patients were not always assessed by the same dermatologist (leading to possible inter-observer variability) and the fact that other factors possibly influencing response were not taken into account. The authors emphasise that the therapeutic range developed in this study (and any therapeutic algorithm based on this) would need to be validated in a prospective patient cohort before it is used in practice.