Brodalumab for the treatment of plaque psoriasis in a real-life setting: a 3 years multicenter retrospective study-IL PSO (Italian landscape psoriasis)

Luigi Gargiulo; Luciano Ibba; Piergiorgio Malagoli; Fabrizio Amoruso; Giuseppe Argenziano; Anna Balato; Federico Bardazzi; Martina Burlando; Carlo Giovanni Carrera; Giovanni Damiani; Paolo Dapavo; Valentina Dini; Gabriella Fabbrocini; Chiara Franchi; Francesca Maria Gaiani; Giampiero Girolomoni; Claudio Guarneri; Claudia Lasagni; Francesco Loconsole; Angelo Valerio Marzano; Matteo Megna; Francesca Sampogna; Massimo Travaglini; Antonio Costanzo; Alessandra Narcisi

doi:10.3389/fmed.2023.1196966

Brodalumab for the treatment of plaque psoriasis in a real-life setting: a 3 years multicenter retrospective study-IL PSO (Italian landscape psoriasis)

Front Med (Lausanne). 2023 Jul 3:10:1196966. doi: 10.3389/fmed.2023.1196966. eCollection 2023.

Authors

Luigi Gargiulo^{1

2}, Luciano Ibba^{1

2}, Piergiorgio Malagoli³, Fabrizio Amoruso⁴, Giuseppe Argenziano⁵, Anna Balato⁵, Federico Bardazzi⁶, Martina Burlando⁷, Carlo Giovanni Carrera⁸, Giovanni Damiani⁹, Paolo Dapavo¹⁰, Valentina Dini¹¹, Gabriella Fabbrocini¹², Chiara Franchi⁹, Francesca Maria Gaiani³, Giampiero Girolomoni¹³, Claudio Guarneri¹⁴, Claudia Lasagni¹⁵, Francesco Loconsole¹⁶, Angelo Valerio Marzano^{8

17}, Matteo Megna¹², Francesca Sampogna¹⁸, Massimo Travaglini¹⁹, Antonio Costanzo^{1

2}, Alessandra Narcisi¹

Affiliations

¹ Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy.
² Department of Biomedical Sciences, Humanitas University, Milan, Italy.
³ Dermatology Unit, Department of Dermatology, Azienda Ospedaliera San Donato Milanese, Milan, Italy.
⁴ Dermatology Unit, Azienda Ospedaliera di Cosenza, Cosenza, Italy.
⁵ Dermatology Unit, University of Campania L. Vanvitelli, Naples, Italy.
⁶ Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola Malpighi, Bologna, Italy.
⁷ Department of Dermatology, Dipartimento di Scienze della Salute (DISSAL), University of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
⁸ Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
⁹ Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy.
¹⁰ Department of Biomedical Science and Human Oncology, Second Dermatologic Clinic, University of Turin, Turin, Italy.
¹¹ Dermatology Unit, Department of Clinical and Experimental Medicine, Ospedale Santa Chiara, Pisa, Italy.
¹² Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
¹³ Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy.
¹⁴ Unit of Dermatology, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, AOU Policlinico G. Martino, Messina, Italy.
¹⁵ Department of Specialized Medicine, Dermatological Clinic, University of Modena, Modena, Italy.
¹⁶ Department of Dermatology, University of Bari, Bari, Italy.
¹⁷ Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
¹⁸ Clinical Epidemiology Unit, Istituto Dermopatico dell'Immacolata (IDI) IRCCS, Rome, Italy.
¹⁹ U.O.S.D. dermatologica-centro per la cura della psoriasi, Ospedale Perrino, Brindisi, Italy.

Abstract

Introduction: Brodalumab is a monoclonal antibody that targets the subunit A of the interleukin-17A receptor (IL17RA), inhibiting the signaling of various isoforms of the IL-17 family. It has been approved for the treatment of moderate-to-severe plaque psoriasis after being evaluated in three Phase-3 trials. However, long-term data on brodalumab in a real-life setting are still limited.

Methods: The aim of this study was to evaluate the long-term effectiveness and safety of brodalumab in psoriasis. We also assessed the drug survival of brodalumab in a 3 years timespan. We conducted a retrospective multicenter study on 606 patients followed up at 14 Italian dermatology units, all treated with brodalumab according to Italian guidelines. Patients' demographics and disease characteristics were retrieved from electronic databases. At baseline and weeks 12, 24, 52, 104 and 156, we evaluated the psoriasis area and severity index (PASI) score and investigated for adverse events. The proportions of patients reaching 75, 90 and 100% (PASI 75, PASI 90 and PASI 100, respectively) improvement in PASI, compared with baseline, were also recorded.

Results: At week 12, 63.53% of the patients reached PASI 90 and 49.17% PASI 100. After 3 years of treatment, 65.22% of patients maintained a complete skin clearance, and 91.30% had an absolute PASI of 2 or less. Patients naïve to biological therapies had better clinical responses at weeks 12, 24 and 52. However, after 2 years of treatment, no significant differences were observed. Body mass index did not interfere with the effectiveness of brodalumab throughout the study. No new safety findings were recorded. After 36 months, 85.64% of our patients were still on treatment with brodalumab.

Conclusion: Our data confirm the effectiveness and the safety of brodalumab in the largest real-life cohort to date, up to 156 weeks.

Keywords: brodalumab; psoriasis; psoriasis treatment; psoriatic arthritis; real-life.

Copyright © 2023 Gargiulo, Ibba, Malagoli, Amoruso, Argenziano, Balato, Bardazzi, Burlando, Carrera, Damiani, Dapavo, Dini, Fabbrocini, Franchi, Gaiani, Girolomoni, Guarneri, Lasagni, Loconsole, Marzano, Megna, Sampogna, Travaglini, Costanzo and Narcisi.