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)

The use of brodalumab in patients with psoriasis who have failed other biologic drugs is an underexplored topic. 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: Using the Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI), we retrospectively evaluated a cohort of 23 patients with psoriasis who underwent a change in 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 four weeks of treatment, continuing 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). Sixty-three point six percent 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.