Brodalumab, an interleukin-17 receptor-A antagonist, appears to improve moderate to severe psoriasis in patients who have not responded to prior anti-interleukin-17A therapies, according to study results published in the Journal of the American Academy of Dermatology.
In the open-label trial, a total of 39 patients with moderate to severe psoriasis were enrolled at 3 sites. Only patients who had previously received either secukinumab or ixekizumab for ≥3 months and did not achieve a 75% reduction in their Psoriasis Area and Severity Index (PASI-75) score from baseline were included.
Participants were treated with a subcutaneous injection of 210 mg brodalumab for ≤16 weeks. The percentage of patients who achieved a score of 0 (clear) or 1 (almost clear) on the Physician’s Global Assessment at 16-week follow-up comprised the primary end point, and a secondary end point included improvement in PASI scores.
Approximately 76%, 50%, and 32% of the 34 patients who completed the trial achieved PASI-75, a 90% reduction in their PASI (PASI-90) score, and a 100% reduction in their PASI (PASI-100) score, respectively, at follow-up. The majority of patients (71%) achieved a static Physician Global Assessment of 0 or 1. In all 39 patients, the last observation showed that 69%, 44%, and 28% of patients achieved PASI-75, PASI-90, and PASI-100 scores, respectively, and approximately 62% of these patients had a static Physician Global Assessment of 0 or 1. Only 6 adverse events were observed, none of which were considered associated with the study drug.
Study limitations include the small patient sample, short follow-up, lack of a randomized control, and the open-label design.
“Overall, these findings suggest that brodalumab may be a good treatment option for psoriasis patients who have failed other biologics, including the anti-IL-17A agents,” the researchers wrote. “While many factors must be considered in choosing the best treatment for psoriasis patients, efficacy is certainly among the most important.”
Kimmel G, Chima M, Kim HJ, et al. Brodalumab in the treatment of moderate-to-severe psoriasis in patients who have previously failed treatment with anti-interleukin-17A therapies [published online May 9, 2019]. J Am Acad Dermatol. doi:10.1016/j.jaad.2019.05.007