Brodalumab is an effective and safe option in the treatment of moderate to severe psoriasis in a real-world setting, including in patients who did not respond to anti-interleukin (IL)-17 therapies, according to results of a retrospective study published in the Journal of the European Academy of Dermatological Venereology.
Although brodalumab has been shown to be efficacious and well-tolerated in clinical trials, its safety and effectiveness in real-world clinical settings has not yet been determined.
To evaluate this, data from 78 patients aged at least 18 years with moderate to severe psoriasis were evaluated (71.8% men; mean age, 47.9±16.5). In total, 94.8% of patients previously received systemic treatments, and 52.6% were bi-naive.
Patients were treated with 210 mg brodalumab by subcutaneous injection at weeks 0, 1, and 2, and every other week thereafter for a total treatment period of 24 weeks. Psoriasis severity was evaluated using the Psoriasis Area and Severity Index (PASI). Quality of life (QOL) and patient satisfaction were evaluated at baseline, week 4, week 12, and week 24.
After 4 weeks, the mean PASI score was reduced by 73%; after 12 weeks, PASI was reduced by 91% compared with baseline (P <.0001). Patients who achieved PASI 90 by week 24 had a significantly lower mean number of comorbidities than those who did not (P =.026). Individuals without obesity were more likely to achieve PASI 90 by week 24 than those with obesity (P =.033). Compared with bio-experienced patients, bio-naive patients were more likely to achieve PASI 90 at week 24 (P <.004). Health-related QOL improved significantly compared with baseline (P <.0001) as did patient satisfaction (P <.01).
After 4 weeks of treatment with brodalumab, 44.4% of patients who had prior failure on anti-IL-17 treatments achieved PASI 75, which increased to 61.1% at week 12 and remained stable through 24 weeks. After week 24, 33.3% of these patients achieved PASI 90.
Limitations to this study include its retrospective design and the small number of patients observed.
Significant improvements in psoriasis severity and QOL were observed by week 4 and continued to improve for the remainder of the treatment period. Brodalumab was well-tolerated, resulting in only a 5% dropout rate. “Larger and longer prospective, population-based studies and retrospective analyses of patient registries are needed to further evaluate the safety and effectiveness of brodalumab under real-world conditions,” the researchers concluded.
Disclosure: This clinical trial was supported by LEO Pharma. Please see the original reference for a full list of authors’ disclosures.
Fargnoli MC, Esposito M, Dapavo P, et al. Brodalumab for the treatment of moderate-to-severe plaque-type psoriasis: a real-life, retrospective 24-week experience. Published online September 11, 2020. J Eur Acad Dermatol Venereol. doi: 10.1111/jdv.16931