Brodalumab efficacy in psoriasis patients with inadequate response to IL-23 or IL-12/23 inhibitors: multicenter Italian retrospective analysis - IL PSO (Italian Landscape Psoriasis)

Diego Orsini; Maria Concetta Fargnoli; Martina Burlando; Anna Campanati; Elena Campione; Claudio Guarneri; Alessandra Narcisi; Paolo Pella; Paolo Romita; Massimo Travaglini; Leonardo Zichichi; Luisa Maria Halina Arancio; Chiara Assorgi; Ginevra Baggini; Riccardo Balestri; Luca Bianchi; Alexandra Maria Giovanna Brunasso; Anna Elisabetta Cagni; Giacomo Caldarola; Gianluca Calianno; Antonio Carpentieri; Martino Carriero; Andrea Carugno; Franco Cona; Antonio Costanzo; Emanuele  Cozzani; Giacomo Dal Bello; Paolo Dapavo; Annunziata Dattola; Antonio Di Tano; Federico Diotallevi; Marianna Donnarumma; Elena De Col; Maria Esposito; Carmen Silvia Fiorella; Marco Galluzzo; Francesca Graziola; Giovanni Carlo Lazzaro Danzuso; Agostina Legori; Matteo Licciardello; Viviana Lora; Piergiorgio Malagoli; Matteo Megna; Federica Mola; Gaia Moretta; Andrea Muracchioli; Attilia Musumeci; Maria Letizia Musumeci; Gianluca Pagnanelli; Vincenzo Panasiti; Eugenio Provenzano; Simone Ribero; Daniele Rizzo; Marco Rubatto; Oriele Sarno; Davide Strippoli; Fabrizio Vaira; Dario Graceffa

doi:10.5826/dpc.1504a6010

Brodalumab efficacy in psoriasis patients with inadequate response to IL-23 or IL-12/23 inhibitors: multicenter Italian retrospective analysis - IL PSO (Italian Landscape Psoriasis)

Authors

Diego Orsini San Gallicano Dermatological Institute (IRCCS), Rome, Italy
Maria Concetta Fargnoli San Gallicano Dermatological Institute (IRCCS), Rome, Italy
Martina Burlando Section of Dermatology, Department of Health Sciences (DiSSal), University of Genoa, Genoa, Italy
Anna Campanati Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy
Elena Campione Dermatology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
Claudio Guarneri Department of Biomedical and Dental Sciences and Morpho Functional Imaging, Section of Dermatology, University of Messina, Italy
Alessandra Narcisi Dermatology Unit, IRCCS Humanitas Research Hospital, 10134 Rozzano, Italy.
Paolo Pella Dermatology Unit, Ospedale degli Infermi, 13875 Biella, Italy.
Paolo Romita Section of Dermatology and Venereology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari "Aldo Moro", Bari, Italy
Massimo Travaglini U.O.S.D. Dermatologica - Centro per la cura della psoriasi, Ospedale A. Perrino, Brindisi, Italy.
Leonardo Zichichi Dermatology Unit, Ospedale S A Antonio Abate, ASP Trapani, 91016, Erice, Italy
Luisa Maria Halina Arancio Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico Milano; ASST Crema, Italy.
Chiara Assorgi Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Science, University of La Sapienza, Rome, Italy
Ginevra Baggini Outpatient Clinic, Section of Dermatology, ASL AL, Alessandria, Italy.
Riccardo Balestri Division of Dermatology, Psoriasis Outpatient Service, APSS, Trento, Italy.
Luca Bianchi Dermatology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
Alexandra Maria Giovanna Brunasso Department of Internal Medicine-Dermatology, Villa Scassi Hospital, ASL3, Genoa, Italy.
Anna Elisabetta Cagni Unità Operativa Dipartimentale di Dermatologia e Venereologia, IRCCS San Gerardo, Milan, Italy.
Giacomo Caldarola Dermatology Unit, Agostino Gemelli University Polyclinic Foundation, IRCCS, Rome, Italy; Section of Dermatology, Department of Translational Medicine and Surgery, Catholic University of the Sacred Heart, Rome, Italy.
Gianluca Calianno Section of Dermatology and Venereology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari "Aldo Moro", Bari, Italy.
Antonio Carpentieri U.O.S.D. Dermatologica - Centro per la cura della psoriasi, Ospedale A. Perrino, Brindisi, Italy.
Martino Carriero Dermatology Outpatient, ASL Taranto, Italy
Andrea Carugno Dermatology Unit, Department of Medicine and Surgery, University of Insubria, Varese, Italy.
Franco Cona Umberto I, City Hospital of Enna, Enna, Italy.
Antonio Costanzo Dermatology Unit, IRCCS Humanitas Research Hospital, 10134 Rozzano, Italy.
Emanuele Cozzani Section of Dermatology, Department of Health Sciences (DiSSal), University of Genoa, Genoa, Italy
Giacomo Dal Bello Section of Dermatology, Department of Medicine, ASST di Mantova, Mantova, Italy
Paolo Dapavo Department of Medical Sciences, Section of Dermatology, University of Turin, 10126 Turin, Italy.
Annunziata Dattola Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Science, University of La Sapienza, Rome, Italy
Antonio Di Tano Department of Biomedical and Dental Sciences and Morpho Functional Imaging, Section of Dermatology, University of Messina, Italy
Federico Diotallevi Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy.
Marianna Donnarumma Dermatology Unit, "Andrea Tortora" Hospital, ASL Salerno, Pagani, Italy.
Elena De Col Unit of Dermatology, Civil Hospital of Imperia, Imperia, Italy.
Maria Esposito Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
Carmen Silvia Fiorella Division of Dermatology, "Mons. Dimiccoli" Hospital, Barletta, 76121, Italy.
Marco Galluzzo Dermatology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
Francesca Graziola Dermatologic Clinic, AOU Maggiore della Carità Hospital, Novara, Italy.
Giovanni Carlo Lazzaro Danzuso U.O.S.D Dermatologia, A.O. 'S.Elia' - Caltanissetta, Caltanissetta, Italy
Agostina Legori UO Dermatologia IRCCS Ospedale Galeazzi & Università degli Studi di Milano, 20157 Milan, Italy.
Matteo Licciardello Section of Dermatology, Koelliker Hospital, Turin, Italy.
Viviana Lora San Gallicano Dermatological Institute (IRCCS), Rome, Italy
Piergiorgio Malagoli Department of Dermatology, Dermatology Unit Azienda Ospedaliera San Donato Milanese, 20097 Milan, Italy.
Matteo Megna Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
Federica Mola Dermatology Unit, ASST Lariana, Como, Italy.
Gaia Moretta Department of Dermatology, Istituto Dermopatico dell'Immacolata IRCCS Roma, Roma, Italy.
Andrea Muracchioli Unit of Dermatology, San Bartolomeo Hospital, La Spezia, Italy.
Attilia Musumeci UOSD Dermatologia, ARNAS Garibaldi, Catania, Italy
Maria Letizia Musumeci UOC Dermatologia, University of Catania, PO "G. Rodolico", AOU Policlinico "G. Rodolico-San Marco", 95123 Catania, Italy
Gianluca Pagnanelli Department of Dermatology, Istituto Dermopatico dell'Immacolata IRCCS Roma, Roma, Italy.
Vincenzo Panasiti Fondazione Policlinico Universitario Campus Bio Medico, Rome, Italy.
Eugenio Provenzano Dermatology Unit, Azienda Ospedaliera di Cosenza, Cosenza, Italy.
Simone Ribero Department of Medical Sciences, Section of Dermatology, University of Turin, 10126 Turin, Italy.
Daniele Rizzo Dermatology Unit, Ospedale S A Antonio Abate, ASP Trapani, 91016, Erice, Italy.
Marco Rubatto Candiolo Cancer Institute, FPO—IRCCS, Candiolo, 10060, Italy
Oriele Sarno Department of Dermatology and Dermosurgery, AOSG San Giuseppe Moscati, 83100 Avellino, Italy.
Davide Strippoli Dermatology Unit, Manzoni Hospital, ASST-Lecco, 23900 Lecco, Italy.
Fabrizio Vaira Unit of Dermatology, IRCCS Ospedale San Raffaele, Milan, Italy.
Dario Graceffa San Gallicano Dermatological Institute (IRCCS), Rome, Italy

Keywords:

Brodalumab, psoriasis, comorbidities, IL-17 inhibitors, IL-23 inhibitors, switch

Abstract

Introduction: The use of brodalumab in patients with psoriasis who have failed other biologic drugs is an under-explored topic; A variable percentage of patients still experience primary therapeutic failure, incomplete response, or progressive loss of treatment efficacy (secondary therapeutic failure). In this context, switching treatments among different mechanisms of action has been explored in previous studies conducted on psoriatic patients. However, criteria providing a clear clinical rationale for such transitions are lacking, and no clear guidance is provided by international guidelines to date.

Objectives: To evaluate the safety and the efficacy of brodalumab in a subgroup of psoriasis patients who already failed anti-IL23 or anti-IL12/23 treatment.

Methods: We retrospectively evaluated, using the PASI and DLQI index, a cohort of 23 patients with psoriasis who underwent a change of therapy with brodalumab exclusively following primary or secondary therapeutic failure of anti-IL-23 or anti-12/23 drugs.

Results: The mean PASI decreased significantly following the introduction of brodalumab after 4 weeks of treatment, and continued to decrease at 16 and 36 weeks, reaching the nadir at 52 weeks (baseline PASI baseline= 14.6 ± 9.2 vs. 52 weeks PASI= 1.1 ± 1.8; p <0.001). The 63.6% of patients reached PASI 100 just after 16 weeks. The same trend of improvement was also observed for the DLQI. The adverse effects observed in our study population were generally mild.

Conclusions: Our results are in line with the current literature and suggest that patients who have failed therapy with IL-23 or IL-12/23 inhibitors may benefit from switching to brodalumab, which could be considered a good choice for patients who need a rapid resolution of the inflammatory skin condition.

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