Despite brodalumad demonstrated efficacy in clinical trials, real‐world data reflecting clinical benefits in unselected patient populations treated in routine clinical practice are limited. Thus, we performed a longitudinal, retrospective, real‐world analysis assessing the long‐term clinical benefits of patients with moderate‐to‐severe psoriasis treated with brodalumab in Greece in the long term (up to 24 months). Main efficacy assessments included changes from baseline in the psoriasis area and severity index (PASI) and proportions of patients achieving at least 50%, 75%, 90% and 100% reduction from baseline in PASI scores (PASI50, PASI75, PASI90 and PASI100) at different timepoints up to 24 months. Other endpoints included changes in the dermatology life quality index (DLQI) and body surface area (BSA) involvement. Data from medical records of 180 patients with moderate‐to‐severe psoriasis treated with brodalumab for up to 24 months were assessed. Following treatment, mean [standard deviation (SD)] PASI scores were decreased across all visits compared to baseline (p < 0.001). The proportion of patients achieving PASI50, PASI75, PASI90 or PASI100 were high as early as at month 1 and consistently tended to increase over time, mainly during the first 6 months. Improvements on disease severity were further reflected by reductions from baseline on BSA scores across all visits (p < 0.001). Concurrent improvements on DLQI scores were observed across all visits (p < 0.001). This retrospective analysis provides real‐world evidence supporting the long‐term efficacy profile of brodalumab in Greek patients with moderate‐to‐severe psoriasis treated in standard clinical practice, which is characterized by a rapid onset of action generally sustained over time.

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histopathologic scores) are missing. Further investigations on GC should be done under more rigorous conditions including standardized instruments to measure treatment outcome.New therapeutic approaches with alternative modes of action for this recalcitrant and relapsing disease are warranted. Transcriptional Janus kinase (JAK)-signal transducer and activator of transcription signalling play a key role in the pathogenesis of other non-caseating granulomatous diseases, and JAK inhibition with tofacitinib results in clinical and histological remission of cutaneous sarcoidosis. 5 Accordingly, JAK inhibitors might be a promising future therapeutic strategy for GC. AcknowledgementsAnke Bartr€ over, Tanja Kleinecke, Silke Bolz and Stefanie Fittkau, medical technical assistants employed by the Institute of Pathology at M€ ulheim an der Ruhr, provided excellent technical assistance. The patients in this manuscript have given written informed consent to publication of their case details.

Brodalumab's clinical efficacy and favorable safety profile have been demonstrated during controlled clinical trials, but real‐world data remain scarce. BrIDGE, an ongoing 104 week, observational, prospective, multicenter study conducted in Greece, enrolled moderate‐to‐severe plaque psoriasis patients, with body surface area (BSA) > 10 or psoriasis area severity index score (PASI) > 10 and dermatology life quality index (DLQI) > 10, based on European consensus, initiating brodalumab treatment as per routine clinical practice. This interim analysis includes evaluations 12–16 weeks following treatment initiation. Key efficacy endpoints included proportion of patients achieving static Physician's Global Assessment (sPGA) score of “clear/almost clear” (0/1) and a reduction ≥75%, 90%, 100% from baseline in PASI (PASI75, PASI90, and PASI100) at weeks 12–16. Other endpoints included time to achieve PASI100, changes in self‐reported DLQI and psoriasis symptom inventory (PSI) at weeks 12–16. From 200 patients (mean age 51.4 years, 70% male, mean disease duration 13.8 years) enrolled, 72.8% achieved sPGA of 0/1, whereas 70.2%, 47.5%, and 32.0% achieved corresponding PASI75, PASI90, and PASI100 responses following 12–16 weeks of brodalumab treatment, according to the “as‐observed” analysis. The mean time to achieve PASI100 was 13.7 ± 1.2 weeks for the 32% who achieved PASI100. Concurrent decreases in mean DLQI and PSI were observed. Furthermore, 90% adherence to brodalumab was noted and nine adverse events were reported. Brodalumab confers substantial clinical improvements short‐term as reflected by high levels of skin clearance in moderate‐to‐severe plaque psoriasis patients within 12–16 weeks of treatment under everyday clinical conditions, followed by improvements in symptoms and quality of life and a favorable safety profile.

further emphasized the importance of elimination diets for GC. 7 A cinnamon-and benzoate-free diet with allergen avoidance for 3 months and 2 years improved lip oedema and orofacial oedema, respectively. Given a growing body of evidence suggesting a link between food allergens and GC, clinicians are increasingly open to incorporating dietary modifications in their clinical practice. 8-10 However, there remain practical challenges associated with elimination diet compliance, in part, due to the difficulties in recognizing which foods contain allergens such as benzoate. 8 While we recognize the practical challenges that come with dietary avoidance of allergens, we express optimism that cinnamon-and benzoate-free diets can be particularly efficacious as adjunct therapy. We agree with Kreuter et al. about the difficulty of treating granulomatous cheilitis, but we believe diet modification and allergen avoidance can enhance response to therapy.