Data from a single-arm, open-label, prospective study indicates that brodalumab can improve health-related quality of life (HRQOL) in patients with psoriasis. These study findings were published in JAAD International.
The ProLOGUE study was conducted from 2017 through 2020 at 15 sites in Japan. Patients (N=73) with plaque psoriasis received 210 mg subcutaneous brodalumab on day 1, weeks 1 and 2, and every 2 weeks through 48 weeks. HRQOL was evaluated using the Dermatology Life Quality Index (DLQI) and European Quality of Life 5-Dimension 5-Level Utility Index (EQ-5D-5L UI) instruments.
The patient population comprised 82.2% men, median aged, 54 (interquartile range [IQR], 44-64) years, of whom 90.4% had head involvement, 63.0% had fingernail involvement, and 42.5% had toenail involvement.
Compared with baseline, at 48 weeks significant improvements were observed in the DLQI subscales of symptoms and feelings (median, 3.0 vs 1.0; P <.0001), daily activities (median, 1.0 vs 0.0; P <.0001), leisure (median, 1.0 vs 0.0; P <.0001), treatment (median, 1.0 vs 0.0; P <.0001), personal relationships (median, 0.0 vs 0.0; P =.0162), and work and school (median, 0.0 vs 0.0; P =.0335). Similarly, the EQ-5D-5L dimension scores of pain or discomfort (median, 2.0 vs 1.0; P <.0001), anxiety or depression (median, 1.0 vs 1.0; P =.0019), and usual activity (median, 1.0 vs 1.0; P =.0049) improved from baseline to 48 weeks, respectively.
No improvement in EQ-5D-5L mobility (P =.6790) or self-care (P =.6719) dimension scores were observed.
Among the patients with DLQI scores of 2 or greater, 6 had Psoriasis Area and Severity Index (PASI) scores of 0 and 7 had scores greater than 0 to 2 or lower. These patients reported itching (100% vs 100%), skin pain (50.0% vs 71.4%), anxiety (16.7% vs 28.6%), depression (16.7% vs 28.6%), and peripheral arthritis (16.7% vs 0.0%), respectively. Most of the patients with PSAI scores of greater than 0 to 2 or lower had head lesions (71.4%).
The major limitation of this study was the small sample size, such that the investigators were unable to evaluate changes to HRQOL among subsets of patients.
This study indicated to the researchers that HRQOL improved in the real-world setting with brodalumab therapy in patients with plaque psoriasis. Incomplete HRQOL improvement was likely due to itching, even among patients with clear skin, they believe.
Disclosure: Several authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.
Miyagi T, Kanai Y, Murotani K, et al. Itching as a critical factor in impaired health-related quality of life in real-life patients with plaque psoriasis achieving clear or almost clear skin: Analysis of the single-arm, open-label, multicenter, prospective ProLOGUE study. JAAD Int. Published online June 22, 2022. doi:10.1016/j.jdin.2022.06.013