Effectiveness of Brodalumab for the Treatment of Moderate-to-Severe Psoriasis: A Retrospective, Real-World Multicenter Study with a Focus on Obese and Multi-Failure Patients-IL PSO (Italian Landscape Psoriasis).
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Orsini Diego, Graceffa Dario, Burlando Martina, Campanati Anna, Campione Elena, Guarneri Claudio, Narcisi Alessandra, Pella Paolo, Romita Paolo, Travaglini Massimo, Zichichi Leonardo, Arancio Luisa Maria Halina, Baggini Ginevra, Balestri Riccardo, Bianchelli Tommaso, Bianchi Luca, Brunasso Alexandra Maria Giovanna, Cagni Anna Elisabetta, Caldarola Giacomo, Calianno Gianluca, Carpentieri Anton, Carriero Martino, Carugno Andrea, Cona Franco, Costanzo Antonio, Cozzani Emanuele Claudio, Dal Bello Giacomo, Danzuso Giovanni Carlo Lazzaro, Dattola Annunziata, Donnarumma Marianna, De Col Elena, Esposito Maria, Fiorella Carmen Silvia, Galluzzo Marco, Graziola Francesca, Licata Gaetano, Licciardello Matteo, Legori Agostina, Malagoli Piergiorgio, Mola Federica, Moretta Gaia, Muracchioli Andrea, Musumeci Attilia, Musumeci Maria Letizia, Pagnanelli Gianluca, Panasiti Vincenzo, Peterle Lucia, Provenzano Eugenio, Rubatto Marco, Sarno Oriele, Strippoli Davide, Vaira Fabrizio, Fargnoli Maria Concetta
Аннотация
Background/Objectives: Brodalumab is a monoclonal antibody against the anti-IL-17 receptor A, approved for patients with moderate-to-severe psoriasis. This retrospective study investigated patients in clinical practice to assess the impact of body weight and previous treatments with biologics on the effectiveness of brodalumab. Methods: Patients were treated according to clinical practice, and assessed at baseline, 16, 36 and 52 weeks by means of the Psoriasis Area Severity Index (PASI) and DLQI score. Overall, 299 patients were included (147 naïve to biologics). Results: Mean PASI was significantly reduced compared with the baseline in the overall population by week 4 and continued to decrease at each study time point (15.9 ± 7.9 at baseline, 5.4 ± 5.3 at week 4, 1.9 ± 3.6 at week 6, 1.0 ± 2.1 at week 36, and 0.8 ± 2.1 at week 52; p < 0.001 at each control). PASI improved significantly both in bio-naïve and bio-experienced patients (p < 0.001). The proportions of patients achieving PASI 75, PASI 90, and PASI 100 were comparable between the bio-naïve and bio-experienced groups at all time points. The percentages of patients who achieved PASI 75 were similar in obese and non-obese subjects at all determinations except the visit performed after 36 weeks of treatment (94.3% non-obese vs. 83.1% obese, p = 0.005). PASI 90 was achieved more frequently among non-obese patients than obese patients after 36 weeks (80.7% vs. 64.4%, p = 0.008) and 52 weeks of treatment (84.1% vs. 71.7%, 0.027). The probability of achieving PASI 75 and PASI 100 was independent of nutritional status at any time during the study. Conclusions: In conclusion, our results confirm that brodalumab has both rapid and sustained effectiveness in patients with moderate-to-severe psoriasis; our results could be extended to patients with multiple risk factors impairing treatment response, such as multiple biological failure and obesity.