Individual Article: Brodalumab Is an Efficacious, Safe, and Cost-Effective IL-17 Receptor Blocker for the Treatment of Moderate-to-Severe Plaque Psoriasis: 2023 Update

October 2023 | Volume 22 | Issue 10 | SF378632s5 | Copyright © October 2023


Published online September 29, 2023

Naiem T. Issa MD PhDa,b, Leon Kircik MDc

aForefront Dermatology, Vienna, VA 
bIssa Research & Consulting, LLC, Springfield, VA 
cIcahn School of Medicine at Mount Sinai, New York, NY; Physicians Skin Care, PLLC, Louisville, KY;  DermResearch, PLLC, Louisville, KY; Skin Sciences, PLLC, Louisville, KY

Abstract
Psoriasis remains a highly prevalent condition in the United States and worldwide. Preclinical research has been triumphant in elucidating the critical immunological pathways involved in psoriasis. There has been an evolution in biologics that paralleled the understanding of these pathways beginning with anti-tumor necrosis factor (TNF) inhibitors and now most recently the interleukin (IL)-23 and IL-17 axes. Numerous evidence-based studies demonstrate the efficacy of these agents for skin clearance in moderate-to-severe plaque psoriasis. Brodalumab, a fully humanized IL-17 receptor A (IL-17RA) antagonist, is wholly unique in that it binds to a cytokine receptor and not a cytokine itself unlike the other biologics indicated for psoriasis. This unique mechanism has lent an advantage where not only is brodalumab effective in treating moderate-to-severe plaque psoriasis, but it is also successful in psoriasis patients whose disease did not respond to other biologics. This review provides a summary of the efficacy of brodalumab in plaque psoriasis and difficult-to-treat locations (ie, scalp, nail, palmoplantar), in patients with psoriasis who failed to achieve minimum clearance with other biologics, and it illuminates the most recent pharmacovigilance data obtained from the past 5 years. Furthermore, the cost effectiveness of brodalumab is also discussed.

J Drugs Dermatol. 2023;22:10(Suppl 1):s5-14.

INTRODUCTION

Psoriasis is a significant health and economic burden. In the United States, the prevalence of psoriasis is estimated to be 7.4 million, which accounts for ~2.2% of the population, with the total economic burden estimated as $35.2 billion of which $11.2 billion is from productivity losses.1 It is also associated with physical and emotional distress, thus leading to a significant reduction in the quality of life of those affected. Given the chronic nature of psoriasis and, therefore, the need for chronic therapy, long-term safe and effective therapeutics are critical.