Brodalumab for the treatment of moderate‐to‐severe plaque‐type psoriasis: a real‐life, retrospective 24‐week experience

Abstract

Background Brodalumab was efficacious and safe in moderate‐to‐severe plaque‐type psoriasis in the AMAGINE trials; published reports under real‐life conditions are limited. Objectives To evaluate the effectiveness and safety of brodalumab in patients with moderate‐to‐severe plaque‐type psoriasis in a real‐world setting. Methods This observational, retrospective study enrolled adult patients (≥18 years) with moderate‐to‐severe plaque‐type psoriasis who underwent 24 weeks of treatment with brodalumab at 17 Italian dermatological centres. Baseline data included demographics, comorbidities, age of onset and duration of psoriasis and previous treatments. Psoriasis Area and Severity Index (PASI), Physician Global Assessment (PGA), static PGA of Genitalia, Dermatology Life Quality Index and patient satisfaction were assessed at weeks 0, 4, 12 and 24; adverse events were recorded. Results Seventy‐eight patients (mean age 47.9 years, 71.8% male, average disease duration 16.8 years) were enrolled. A rapid and significant reduction in mean PASI score was observed after 4 weeks of treatment, decreasing further at weeks 12 and 24 (all P < 0.0001 vs. baseline). A higher number of cardiometabolic comorbidities and previous therapies were negatively associated with the achievement of PASI 90 at all assessments. Brodalumab was effective in bio‐experienced patients, including those who had failed on anti‐interleukin (IL)‐17 therapies. Quality of life and patient satisfaction increased significantly during treatment (P < 0.0001 and P < 0.01 vs. baseline, respectively). Treatment was interrupted in 9 (11.5%) patients due to adverse events (n = 4), lack of efficacy (n = 3), lost to follow‐up (n = 1) and surgical procedure (n = 1). Conclusions Brodalumab is effective and safe in the treatment of moderate‐to‐severe psoriasis in a real‐world setting, including in patients with failure to anti‐IL17 therapies.

Use of brodalumab for the treatment of chronic plaque psoriasis: a one-year real-life study in the Lazio region, Italy

“…Similarly, 88.9% of the patients achieved PGA-G scores of 0/1 at 12 weeks, which remained stable up to Week 24. Treatment with brodalumab was interrupted for adverse events in four, lack of efficacy in three, lost at follow-up in one, and surgical intervention in one patient [48]. The results of the clinical response at Week 12 were consistent with data from AMAGINE-1/2/3 studies regarding the PASI 75, PASI 90, and PASI 100.…”

“…However, these results were not consistent with those from a post-hoc analysis of the AMADINE-2 and AMAGINE-3 trials regarding the achievement of PASI 90 at Week 12 in that, in this real-life study, the majority of patients were bio-naïve (47.8% of patients). The overall good tolerability profile of brodalumab was confirmed [48].…”

“…To date, there are few real-life studies evaluating the efficacy of brodalumab in patients with moderate-to-severe psoriasis. The BRILLIANT Working Group was responsible for evaluating the efficacy and safety of brodalumab through a retrospective 24-week analysis of data derived from 17 Italian dermatological centers [48]. Data from 78 patients with moderate-to-severe plaque-type psoriasis included demographics, comorbidities, disease features, and prior treatments.…”

Effectiveness of brodalumab in achieving treatment satisfaction for patients with plaque psoriasis: The ProLOGUE study

“…In Phase III, randomized, placebo-controlled, double-blind, parallel-group comparative studies conducted globally in patients with moderateto-severe plaque psoriasis, brodalumab has shown significant clinical benefit and an acceptable safety profile [4,15]. Although treatment with brodalumab was associated with significant reductions in the Psoriasis Area and Severity Index (PASI) score and body surface area (BSA) vs placebo in randomized controlled trials (RCTs) [4,11,15,16], evidence of its effectiveness in daily clinical practice is limited [17][18][19][20]. Moreover, the effectiveness of brodalumab in improving patient satisfaction in terms of lesion improvement has not been fully elucidated in real-life clinical settings.…”

Efficacy of Brodalumab and Guselkumab in Patients with Moderate-to-Severe Plaque Psoriasis Who are Inadequate Responders to Ustekinumab: A Matching Adjusted Indirect Comparison

“…6 Brodalumab and guselkumab have also shown effectiveness in long-term, real-world settings, including in patients with failure to anti-IL17 therapies. [23][24][25][26] In the absence of direct comparative trials of biological therapies for psoriasis, several network meta-analyses have been performed. In one of these, both brodalumab and guselkumab were shown to have greater short-term efficacy (ie, 10-16 weeks) when given as induction therapy than tildrakizumab, ustekinumab, TNF-α inhibitors and non-biologic systemic treatments at inducing all levels of PASI response.…”