consequences (eg, development of antidrug antibodies), which may limit the efficacy of subsequent biologic therapies.36 Many factors should be considered when selecting the optimal therapy for a patient with psoriasis.37,38 Clinical studies show that brodalumab is a suitable option for patients seeking both rapid and long-term relief from psoriasis symptoms. In a pooled analysis of the AMAGINE-2/-3 trials, the time to onset of brodalumab treatment effect was shorter compared with ustekinumab (median time to PASI 75, 4.2 vs 9.4 weeks, respectively). Indirect comparisons of brodalumab with other IL-17 inhibitors, including secukinumab and ixekizumab, also indicate a more rapid onset of treatment effect.39 As demonstrated here, brodalumab also induces meaningful treatment responses in patients previously treated with one or more of these other biologics with inadequate improvement, with an immunogenicity profile that may maintain continued efficacy in these patients. Given this evidence, brodalumab is a viable treatment for patients who have failed or lost efficacy to a single prior biologic, while also offering long-term skin clearance for patients with a history of multiple biologic drug failures.
DISCLOSURES
MGL is an employee of Mount Sinai and receives research funds
from AbbVie, Amgen, Arcutis, Avotres, Boehringer Ingelheim,
Dermavant, Eli Lilly, Incyte, Janssen Research & Development,
LLC, Ortho Dermatologics (a division of Bausch Health US,
LLC), Regeneron, and UCB; and is a consultant for Aditum
Bio, AnaptysBio, Almirall, Arcutis, Aristea, Arrive Technology,
Avotres Therapeutics, BioMx, Boehringer Ingelheim, Bristol
Myers Squibb, Cara Therapeutics, Castle Biosciences, Corrona,
Dermavant Sciences, Dr. Reddy, Evelo, Evommune, Facilitate
International Dermatologic Education, Forte, Foundation
for Research and Education in Dermatology, Helsinn, LEO
Pharma, Meiji, Mindera, Pfizer, and Verrica. AM has received
compensation from or served as an investigator, consultant,
advisory board member, or speaker for AbbVie, Allergan,
Amgen, Anacor Pharmaceuticals, Boehringer Ingelheim,
Celgene Corporation, Dermira, Eli Lilly & Co, Galderma,
Janssen Biotech, LEO Pharma, Merck & Co, Neothetics, Novartis
AG, Pfizer, Regeneron Pharmaceuticals, Symbio/Maruho, Vitae,
and Xenoport. EL is an investigator, consultant, or speaker for
AbbVie, Almirall, Amgen, AnaptysBio, Arcutis, Athenex, Bristol
Myers Squibb, Cara Therapeutics, ChemoCentryx, Dermavant
Sciences, Dr Reddy, Eli Lilly, ENDO Pharmaceuticals, Evelo,
Evommune, Gage, Galderma, LEO Pharma, MC2 Therapeutics,
Mindera, Novartis, Ortho Dermatologics (a division of Bausch
Health US, LLC), Regeneron, Sanofi/Genzyme, and UCB. GH
has received grants, research support, or honoraria from or is
on the advisory board for AbbVie, Athenex, BMS, Boehringer
Ingelheim, Bond Avillion, Celgene, Dermavant, Incyte, Janssen,
LEO, Lilly, MC2, Novartis, Ortho Dermatologics (a division
of Bausch Health US, LLC), Pellepharm, Pfizer, Regeneron,
Sanofi/Genzyme, SUN, and UCB. AJ is an employee of Ortho
Dermatologics (a division of Bausch Health US, LLC).
ACKNOWLEDGMENTS
This study was sponsored by Ortho Dermatologics. Medical
writing and editorial support were funded by Ortho Dermatologics
and provided under the direction of the authors by Samantha
Agron, MD, and Jenna Lewis, MA, ELS, of MedThink SciCom.
Ortho Dermatologics is a division of Bausch Health US, LLC.
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15. Mease P. Psoriatic arthritis and spondyloarthritis assessment and management update. Curr Opin Rheumatol. 2013;25:287-296.
16. Miossec P, Kolls JK. Targeting IL-17 and TH17 cells in chronic inflammation. Nat Rev Drug Discov. 2012;11:763-776.
17. Papp K, Menter A, Leonardi C, et al. Long-term efficacy and safety of brodalumab in psoriasis through 120 weeks and after withdrawal and retreatment: subgroup analysis of a randomized phase III trial (AMAGINE-1). Br J Dermatol. 2020;183:1037-1048.
18. Puig L, Lebwohl M, Bachelez H, et al. Long-term efficacy and safety of brodalumab in the treatment of psoriasis: 120-week results from the randomized, double-blind, placebo- and active comparator-controlled phase 3 AMAGINE-2 trial. J Am Acad Dermatol. 2020;82:352-359.
19. Papp KA, Reich K, Paul C, et al. A prospective phase III, randomized, doubleblind, placebo-controlled study of brodalumab in patients with moderate-tosevere plaque psoriasis. Br J Dermatol. 2016;175:273-286.
20. Bianchi E, Rogge L. The IL-23/IL-17 pathway in human chronic inflammatory diseases-new insight from genetics and targeted therapies. Genes Immun. 2019;20:415-425.
21. Levin EC, Gupta R, Brown G, et al. Biologic fatigue in psoriasis. J Dermatolog Treat. 2014;25:78-82.
22. Pang Y, Khatri A, Suleiman AA, Othman AA. Clinical pharmacokinetics and pharmacodynamics of risankizumab in psoriasis patients. Clin Pharmacokinet. 2020;59:311-326.
23. Langley RG, Armstrong AW, Lebwohl MG, et al. Efficacy and safety of brodalumab in patients with psoriasis who had inadequate responses to ustekinumab: subgroup analysis of two randomized phase III trials. Br J Dermatol. 2019;180:306-314.
2. Lebwohl M, Strober B, Menter A, et al. Phase 3 studies comparing brodalumab with ustekinumab in psoriasis. N Engl J Med. 2015;373:1318- 1328.
3. Bagel J, Lebwohl M, Israel RJ, Jacobson A. Immunogenicity and skin clearance recapture in clinical studies of brodalumab. J Am Acad Dermatol. 2020;82:344-351.
4. Sawyer LM, Cornic L, Levin LÃ…, et al. Long-term efficacy of novel therapies in moderate-to-severe plaque psoriasis: a systematic review and network meta-analysis of PASI response. J Eur Acad Dermatol Venereol. 2019;33:355- 366.
5. Menter A, Armstrong A, Van Voorhees A, et al. Brodalumab to the rescue: efficacy and safety of brodalumab in patients with psoriasis and prior exposure or inadequate response to biologics. Dermatol Ther (Heidelb). 2020;10:615-621.
6. Tsai Y-C, Tsai T-F. Switching biologics in psoriasis - practical guidance and evidence to support. Expert Rev Clin Pharmacol. 2020;13:493-503.
7. Reid C, Griffiths CEM. Psoriasis and treatment: past, present and future aspects. Acta Derm Venereol. 2020;100(3):adv00032.
8. Fieldhouse KA, Ukaibe S, Crowley EL, et al. Inflammatory bowel disease in patients with psoriasis treated with interleukin-17 inhibitors. Drugs Context. 2020;9:2020-2-1.
9. Merola JF, Qureshi A, Elaine Husni M. Underdiagnosed and undertreated psoriasis: nuances of treating psoriasis affecting the scalp, face, intertriginous areas, genitals, hands, feet, and nails. Dermatol Ther. 2018;31:e12589.
10. Armstrong AW, Puig L, Joshi A, et al. Comparison of biologics and oral treatments for plaque psoriasis: a meta-analysis. JAMA Dermatol. 2020;156:258-269.
11. Pithadia DJ, Reynolds KA, Lee EB, et al. Tildrakizumab in the treatment of psoriasis: latest evidence and place in therapy. Ther Adv Chronic Dis. 2019;10: 2040622319865658.
12. Wang T-S, Tsai T-F. Biologics switch in psoriasis. Immunotherapy. 2019;11:531- 541.
13. Siliq [package insert]. Bridgewater, NJ: Bausch Health US, LLC; 2017.
14. Strzępa A, Szczepanik M. IL-17-expressing cells as a potential therapeutic target for treatment of immunological disorders. Pharmacol Rep. 2011;63:30- 44.
15. Mease P. Psoriatic arthritis and spondyloarthritis assessment and management update. Curr Opin Rheumatol. 2013;25:287-296.
16. Miossec P, Kolls JK. Targeting IL-17 and TH17 cells in chronic inflammation. Nat Rev Drug Discov. 2012;11:763-776.
17. Papp K, Menter A, Leonardi C, et al. Long-term efficacy and safety of brodalumab in psoriasis through 120 weeks and after withdrawal and retreatment: subgroup analysis of a randomized phase III trial (AMAGINE-1). Br J Dermatol. 2020;183:1037-1048.
18. Puig L, Lebwohl M, Bachelez H, et al. Long-term efficacy and safety of brodalumab in the treatment of psoriasis: 120-week results from the randomized, double-blind, placebo- and active comparator-controlled phase 3 AMAGINE-2 trial. J Am Acad Dermatol. 2020;82:352-359.
19. Papp KA, Reich K, Paul C, et al. A prospective phase III, randomized, doubleblind, placebo-controlled study of brodalumab in patients with moderate-tosevere plaque psoriasis. Br J Dermatol. 2016;175:273-286.
20. Bianchi E, Rogge L. The IL-23/IL-17 pathway in human chronic inflammatory diseases-new insight from genetics and targeted therapies. Genes Immun. 2019;20:415-425.
21. Levin EC, Gupta R, Brown G, et al. Biologic fatigue in psoriasis. J Dermatolog Treat. 2014;25:78-82.
22. Pang Y, Khatri A, Suleiman AA, Othman AA. Clinical pharmacokinetics and pharmacodynamics of risankizumab in psoriasis patients. Clin Pharmacokinet. 2020;59:311-326.
23. Langley RG, Armstrong AW, Lebwohl MG, et al. Efficacy and safety of brodalumab in patients with psoriasis who had inadequate responses to ustekinumab: subgroup analysis of two randomized phase III trials. Br J Dermatol. 2019;180:306-314.
