Spotlight on brodalumab in the treatment of plaque psoriasis: the evidence to date

Figures & data

Table 1 Comparing week 12 AMAGINE 2 and AMAGINE 3 PASI 75, 90 and 100 results with extension study (week 52 and week 108 results are obtained from patients assuming brodalumab 210 mg Q2W during the maintenance and long-term extension phases)

Week 12 AMAGINE 2	Week 12 AMAGINE 3	Week 52 AMAGINE 2–3	Week 108 AMAGINE 2–3
PASI 75
66,6 % for brodalumab 140 mg group 86,3 % for brodalumab 210 mg group 70 % for ustekinumab group and 8,1 % for placebo group	69,2 % for brodalumab 140 mg group 85,1 % for brodalumab 210 mg group 69,3 % for ustekinumab group and 6 % for placebo group	93,1 % for brodalumab 210 mg group	91,0% for brodalumab 210 mg group
PASI 90
		86,4% for brodalumab 210 mg group	79,7% for brodalumab 210 mg group
PASI 100
25,7 % for brodalumab 140 mg group 44,4 % for brodalumab 210 mg group 21,7 % for ustekinumab group, and 0,6 % for placebo group	27 % for brodalumab 140 mg group 36,7 % for brodalumab 210 mg group 18,5 % for ustekinumab group and 0,3 % for placebo group	66,5 % for brodalumab 210 mg group	61,9 % for brodalumab 210 mg group

Notes: Data from Lebwohl M et al¹⁸ and Papp KA et al.²⁸

Table 2 Safety data from AMAGINE-2 and AMAGINE-3 trials

Study protocols	Most common AE	Severe AEs
Study protocols	Most common AEs (rates per 100 patient-over 2.3 years)	Severe AEs
AMAGINE-2
N=1800 patients with moderate-to-severe plaque psoriasis Placebo Q2W, Brodalumab Q2W 140 mg Brodalumab Q2W 210 mg Ustekinumab as per label Follow up 52 weeks, extended to 120 weeks	Injection site reaction (4.5%) Candida infections (4.1%) Nasopharyngitis (3%)	4 patients committed suicide Neutropenia (0.2 for AMAGINE-2 and 1.5 for AMAGINE-3) Sepsis (0.1) , (0.1)
AMAGINE-3
N=1800 patients with moderate-to-severe plaque psoriasis Placebo Q2W Brodalumab Q2W 140 mg Brodalumab Q2W 210 mg Ustekinumab as per label Follow up 52 weeks, extended to 120 weeks	Respiratory tract infection (1.8%) Arthralgias (1.1%) Depressed mood (1.5%)	MACE (0.2) , (0.7) Serious infection (1.4%)

Figure 1 IL-17A and IL-17C are involved in a mutual relationship wherein IL-17A strongly induces IL-17C in keratinocytes and IL-17C is capable of synthesizing IL-17A in T lymphocytes. IL-17C may also play a role in other skin inflammatory diseases; inhibiting IL-17C may therefore be beneficial in both psoriasis and AD patients: antibody-dependent blockade of IL-17C inhibited cutaneous inflammation in the IL-23-induced psoriasis model and even in AD-like inflammation in mice.

Abbreviations: AD, atopic dermatitis; DC, dendritic cell; IL, interleukin; Th, lymphocyte T helper.

Lebwohl M, Strober B, Menter A, et al. Phase 3 studies comparing brodalumab with ustekinumab in psoriasis. N Engl J Med. 2015;373(14):1318–1328. doi:10.1056/NEJMoa150382426422722

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Papp KA, Leonardi C, Menter A, et al. Brodalumab, an anti-interleukin-17- receptor antibody for psoriasis. N Engl J Med. 2012;366(13):1181–1189. doi:10.1056/NEJMoa110901722455412

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