Patient-Level Cumulative Clinical Benefit of Brodalumab Over 52 Weeks: A Multicentre Real-World Study-IL PSO (Italian...

Conventional Psoriasis Area and Severity Index (PASI) response rates provide a cross-sectional assessment of treatment effectiveness but do not capture the speed, magnitude, and persistence of clinical improvement. This study evaluated the patient-level cumulative clinical benefit of brodalumab over 52 weeks in routine clinical practice.

This multicentre, retrospective, observational study included adults with moderate-to-severe plaque psoriasis treated with brodalumab within the Italian Landscape Psoriasis database. The primary analysis included patients with PASI assessments at baseline and Weeks 16, 32, and 52. Individual percentage PASI improvement trajectories were integrated using the trapezoidal area under the curve and expressed as normalized cumulative clinical benefit and clearance-equivalent days. Baseline factors associated with cumulative benefit were assessed using multivariable median quantile regression.

Among 858 patients eligible for the 52-week analysis, 764 had complete longitudinal PASI data, and 645 were included in the multivariable analysis. Median PASI decreased from 14.7 at baseline to 0.0 at Weeks 16, 32, and 52. At Week 52, 93.1%, 86.1%, and 70.4% of patients achieved PASI 75, PASI 90, and PASI 100, respectively. Median normalized cumulative clinical benefit was 97.4% (interquartile range, 90.0-100.0), corresponding to 300.0 clearance-equivalent days (277.2-308.0). Palmoplantar involvement was independently associated with lower cumulative benefit (adjusted median difference, - 3.21 percentage points; 95% confidence interval, - 6.29 to - 0.87), whereas scalp or facial involvement was associated with modestly higher benefit (+ 1.39; 0.38-3.27). Longer psoriasis duration was associated with a small increase in cumulative benefit.

Brodalumab provided rapid, deep, and sustained disease control over 52 weeks. Patient-level cumulative outcomes may complement conventional PASI response rates by capturing the overall longitudinal treatment benefit.