Brodalumab improves itch and other symptoms in patients with moderate to severe psoriasis, according to results from 3 randomized, controlled, phase 3 clinical trials: AMAGINE-1, AMAGINE-2, and AMAGINE-3. 

Alice Gottlieb, MD, PhD, professor of dermatology at New York Medical College, and colleagues reported their findings in the Journal of the European Academy of Dermatology and Venereology.

Brodalumab is an interleukin-17 receptor A (IL-17 RA) antagonist. IL-17 drives inflammation in psoriasis and mediates itch. By blocking signaling through IL-17RA, brodalumab can relieve symptoms.

AMAGINE-1 was a placebo-controlled trial evaluating brodalumab (140 or 210 mg every 2 weeks) during a 12-week induction phase, followed by a maintenance phase through week 52. AMAGINE-2/3 were similarly designed; however, both studies were placebo and active comparator controlled, using ustekinumab as an active agent. Placebo comparisons were made across all 3 studies. Ustekinumab comparisons were made using AMAGINE-2/3 only. The psoriasis symptom inventory (PSI), a validated patient-reported instrument designed to assess severity of cutaneous symptoms, was used to assess symptom response from weeks 2 through 12 and through week 52. 

A total of 4225 patients were included in the study. In AMAGINE-1/2/3, brodalumab improved PSI total and itch scores from week 2 through 12 compared with placebo (both P <.001). In AMAGINE-2/3, brodalumab 210 mg improved PSI total and itch scores (at 2 weeks, 22.1% and 36.5%, respectively) more quickly than ustekinumab (at 2 weeks, 6.9% and 17.1%, respectively), with greater overall improvement in itch as assessed at week 52.

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“The present study further supports the efficacy of brodalumab for the treatment of psoriasis by showing improvements in itch and other discrete symptoms that may be overlooked in a general assessment of lesional severity,” the authors wrote. “Furthermore, these results provide additional evidence for a link between IL-17 signaling and cutaneous symptoms of psoriasis,” underscoring the value of IL-17RA as a target for psoriasis therapy. 

Disclosures: Funding for the study was provided by Valeant Pharmaceuticals North America LLC. Several authors declare affiliations with the pharmaceutical industry. 

Reference

Gottlieb AB, Gordon K, Hsu S, et al. Improvement in itch and other psoriasis symptoms with brodalumab in phase 3 randomized controlled trials [published online March 6, 2018]. J Eur Acad Dermatol Venereol. doi:10.1111/jdv.14913