physician’s global assessment [sPGA] of ≥3 or persistent sPGA of 2 over a ≥4-week period). Patients who received ustekinumab and had inadequate treatment response after week 16 continued on ustekinumab. During the open-label extension (from weeks 52 to 120), patients in the ustekinumab group switched to brodalumab 210 mg every 2 weeks.2
A similar proportion of patients in the AMAGINE-2 and AMAGINE-3 trials originally receiving ustekinumab were rescued with brodalumab therapy at week 16 (AMAGINE-2, 18% [55/300]; AMAGINE-3, 22% [69/313]). In a pooled analysis of the AMAGINE-2/-3 trials, brodalumab rescue of patients in the ustekinumab group was effective in those both with and without prior biologic treatment. Between weeks 12 and 52, the proportion of patients achieving PASI 75, PASI 90, and PASI 100 was greater among patients rescued with brodalumab compared with those who received only ustekinumab. Of the ustekinumab-treated patients rescued with brodalumab (n=124), 36% achieved complete skin clearance at 52 weeks, vs only 5% who continued with ustekinumab (Figure 3). Among patients in the ustekinumab group rescued with brodalumab, 26% with prior biologic exposure achieved PASI 100 by week 52, compared with 42% who were biologic naive. However, among inadequate treatment responders after week 16 who continued ustekinumab without brodalumab rescue, only 2% of the biologic experienced and 7% of the biologic naive achieved PASI 100.23
Brodalumab Induces Long-term Treatment Response, Even After Failure of Multiple Biologics
Because of the chronic nature of psoriasis and the potential loss of biologic treatment effect over time, patients may be prescribed various drugs throughout the course of their disease.6 Therefore, it is important for clinicians to consider drug efficacy after the lack or loss of response to multiple biologics. The potential of brodalumab as a therapy for patients with single or multiple biologic failures was considered in a post hoc analysis of the AMAGINE-2/-3 trials, which stratified patients who received brodalumab by number of prior biologic failures (n=408): 1 biologic (n=160), 2 biologics (n=112), or ≥3 biologics (n=136). After 120 weeks of treatment with brodalumab, PASI 75 rates were 82%, 84%, and 93%, and PASI 100 rates were 50%, 55%, and 54% in the subgroups who received 1, 2, or ≥3 prior biologics, respectively (Figure 4). These results demonstrate that efficacy rates were similar in patients who received a single previous biologic relative to those with more extensive experience. This suggests that brodalumab is an appropriate treatment option for patients seeking relief from psoriasis after a single or multiple inadequate trials of biologics and highlights that brodalumab treatment can be effective throughout a period of more than 2 years.31
A similar proportion of patients in the AMAGINE-2 and AMAGINE-3 trials originally receiving ustekinumab were rescued with brodalumab therapy at week 16 (AMAGINE-2, 18% [55/300]; AMAGINE-3, 22% [69/313]). In a pooled analysis of the AMAGINE-2/-3 trials, brodalumab rescue of patients in the ustekinumab group was effective in those both with and without prior biologic treatment. Between weeks 12 and 52, the proportion of patients achieving PASI 75, PASI 90, and PASI 100 was greater among patients rescued with brodalumab compared with those who received only ustekinumab. Of the ustekinumab-treated patients rescued with brodalumab (n=124), 36% achieved complete skin clearance at 52 weeks, vs only 5% who continued with ustekinumab (Figure 3). Among patients in the ustekinumab group rescued with brodalumab, 26% with prior biologic exposure achieved PASI 100 by week 52, compared with 42% who were biologic naive. However, among inadequate treatment responders after week 16 who continued ustekinumab without brodalumab rescue, only 2% of the biologic experienced and 7% of the biologic naive achieved PASI 100.23
Brodalumab Induces Long-term Treatment Response, Even After Failure of Multiple Biologics
Because of the chronic nature of psoriasis and the potential loss of biologic treatment effect over time, patients may be prescribed various drugs throughout the course of their disease.6 Therefore, it is important for clinicians to consider drug efficacy after the lack or loss of response to multiple biologics. The potential of brodalumab as a therapy for patients with single or multiple biologic failures was considered in a post hoc analysis of the AMAGINE-2/-3 trials, which stratified patients who received brodalumab by number of prior biologic failures (n=408): 1 biologic (n=160), 2 biologics (n=112), or ≥3 biologics (n=136). After 120 weeks of treatment with brodalumab, PASI 75 rates were 82%, 84%, and 93%, and PASI 100 rates were 50%, 55%, and 54% in the subgroups who received 1, 2, or ≥3 prior biologics, respectively (Figure 4). These results demonstrate that efficacy rates were similar in patients who received a single previous biologic relative to those with more extensive experience. This suggests that brodalumab is an appropriate treatment option for patients seeking relief from psoriasis after a single or multiple inadequate trials of biologics and highlights that brodalumab treatment can be effective throughout a period of more than 2 years.31
