Brodalumab Promising for the Treatment of Plaque Psoriasis in a Real-World Setting

Brodalumab was highly effective and associated with a tolerable safety profile for the treatment of moderate to severe chronic plaque psoriasis (PsO) in a real-world setting, according to study data published in the Journal of the European Academy of Dermatology & Venerology.

Patients (N=91) with moderate to severe chronic plaque PsO who received brodalumab treatment at the National and Kapodistrian University of Athens in Greece from 2018 through 2021 were retrospectively reviewed for this study. The primary outcome was early “super” response at weeks 12 and 16, defined as a Psoriasis Area Severity Index (PASI) score 1 point.

Patients comprised 63.7% men, who were median age 52.5 (range, 18-77) years at brodalumab initiation, age 28 (range, 5-73) years at PsO onset, median BMI was 26.88 (range, 19.5-40.5) kg/m², 59.3% had comorbidities, and 25.3% had concomitant psoriatic arthritis.

At baseline, mean PASI was 10.3 (standard deviation [SD], 6.22) points. The average PASI score decreased to 0.9 points at weeks 12 and 16, 1.2 points at weeks 24 and 52, and 0.5 points at week 104.

The percentage of patients who had a PASI score of 3 points or fewer at baseline was 8.6%, which increased to 88.9% at weeks 12 and 16, and 97.0% at week 104.

Three-quarters (75.9%) of patients were super-responders at weeks 12 and 16. No patient characteristics were significant predictors for initial super response to brodalumab. Predictors negatively related with response that were trending toward significance included having more than 3 comorbidities (odds ratio [OR], 0.159; P =.050), previous treatment with more than 2 systemic therapies (OR, 0.180; P =.056), and obesity (OR, 0.197; P =.069).

Nearly a quarter (24.2%) of patients discontinued brodalumab prematurely due to secondary failure (n=11), adverse events (n=6), primary failure (n=2), noncompliance (n=2), and unknown motivation (n=1). For patients who discontinued due to adverse events, the most common event was arthralgia in patients without established psoriatic arthritis (n=4).

At week 104, 77.32% of patients remained on brodalumab treatment. Fewer patients remained on treatment who did not have initial response (P <.001) or received prior treatment with interleukin (IL)-77 inhibitors (P =.0431).

The limitations of this study included the retrospective design and the relatively small sample size.

“Our study confirms the high effectiveness and good safety profile of brodalumab in the real-world setting” for the treatment of moderate to severe, chronic plaque PsO, investigators concluded.

Disclosure: Several authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.