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Circulating Brodalumab Levels and Therapy Outcomes in Patients With Psoriasis Treated With Brodalumab: A Case Series

C. Enevold, N. Loft, A. Bregnhøj, C. Zachariae, L. Iversen, L. Skov, C. H. Nielsen

JAMA dermatology, 2022

7 participants · 12 citations

Abstract

Importance

Given the possible treatment modalities in psoriasis management, little is known about whether drug monitoring is associated with response rate.

Objective

To determine whether drug monitoring is associated with response to brodalumab therapy.

Design

A multicenter case series study of patients with psoriasis treated with brodalumab whose treatment with previous IL-17A inhibitor therapy failed. Patients were recruited from the Departments of Dermatology at Gentofte and Aarhus University Hospitals, Denmark, between 2018 and 2020. Patient visits were conducted after 4 and 12 weeks of therapy. Patients not achieving Psoriasis Area and Severity Index 75% improvement from baseline (PASI 75) after 12 weeks were discontinued and considered nonresponders. Patients maintaining PASI 75 response were followed up for up to 52 weeks.

Exposure

Treatment with brodalumab, 210 mg, at weeks 0, 1, 2, then every 2 weeks.

Main Outcomes and Measures

Outcome measures were PASI reductions vs brodalumab levels and antibrodalumab antibodies.

Results

Twenty patients with psoriasis (13 [65%] were male; median age, 50 years [range, 19-66 years]) were included. After 12 weeks of therapy, patients with quantifiable levels of brodalumab (≥0.05 μg/mL) experienced significantly higher PASI reductions than those without (median, 93%; range, 61%-100% vs median, -3; range, -49% to 94%, respectively; P = .006). After 12 weeks of therapy, 4 of 5 patients (80%) not achieving PASI 75 had subquantifiable…

How strong is the evidence?

Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 7 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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