Real-World Effectiveness of Brodalumab in Challenging Psoriasis Subgroups: Insights from the PSO-TARGET Cohort

Biologic therapies have significantly improved treatment options for patients with moderate-to-severe psoriasis. Brodalumab's effectiveness, efficacy, and safety have been demonstrated in clinical trials. Real-world data are now available to confirm these outcomes in diverse populations, including those at higher risk of reduced treatment response.

This observational, prospective, multicentre study included 143 patients between 2020 and 2022. Baseline data included demographics, medical history, Psoriasis Area and Severity Index (PASI), presence of high-impact areas (HIA), Dermatology Life Quality Index (DLQI), comorbidities, and prior treatments. Follow-up visits (weeks 12-16 and 52) documented PASI, DLQI, and drug survival. The analysis focused on four potential modifiers of treatment response: body mass index (BMI), biologic treatment history, number of HIA, and age.

Brodalumab demonstrated effectiveness and safety in patients with moderate-to-severe psoriasis requiring systemic therapy. Time of exposure to brodalumab was 13 months (52 weeks ± 4). At weeks 12/16, 49.6% achieved PASI 100, sustained in 61.9% at week 52. DLQI scores improved at both follow-ups, with increased proportions achieving DLQI ≤ 1. At week 52, PASI 100 and DLQI ≤ 1 were observed in 62.5% and 73.2% of patients with overweight, 48.6% and 61.8% of patients with obesity, respectively. Among older patients, 60.9% achieved PASI 100 and 65.2% reported DLQI ≤ 1. In patients with ≥ 2 HIA, 60.0% achieved PASI 100 and 68.9% experienced DLQI ≤ 1. Response was favourable across treatment history: 65.5% of bionaïve and 51.7% of bioexperienced patients achieved PASI 100; DLQI ≤ 1 was observed in 75.0% and 64.3%, respectively. Drug survival was high overall (94.6%) and across subgroups (88.3-100%). The safety profile was consistent with clinical trial data.

Real-world data supports brodalumab use as a valuable long-term treatment for HIA and specific subpopulations such as older, bionaïve, bioexperienced, and patients with overweight or obesity. This article is a post hoc analysis of the PSO-TARGET clinical trial (Evaluation of the Sensitivity and Specificity of a Novel Quality of Life Tool to Assess the Treatment Satisfaction in Psoriasis Patients).

ClinicalTrial.gov, NCT04765332.