Real-world experience with brodalumab in a Portuguese cohort of patients with moderate-to-severe psoriasis

Background: Brodalumab is a monoclonal antibody directed to the IL-17 receptor A, approved for the treatment of moderate-to-severe psoriasis. In phase III clinical trials, brodalumab showed clinical efficacy and a favourable safety profile. However, real-world data on brodalumab treatment are still limited. This study aimed to evaluate the real-world efficacy and safety of brodalumab treatment in a Portuguese population. Methods: This is a retrospective, observational, multicentre study of patients with moderate-to-severe plaque- type psoriasis treated with brodalumab between January 2019 and August 2022. The follow-up period was 74 weeks. Brodalumab efficacy was accessed by the percentage of patients reaching the Psoriasis Area Severity Index (PASI) 75, 90 and 100 responses and by improvement in absolute PASI and Dermatology Life Quality Index (DLQI) scores. Drug survival of brodalumab treatment, causes of treatment discontinuation and adverse events were also reported. Results: A total of 126 patients were included. Four weeks after treatment initiation, 83%, 57% and 29% of patients reached PASI 75, 90 and 100, respectively. These values increased to 96%, 93% and 66% at 74 weeks. A significant reduction in PASI score was observed after 4 weeks of brodalumab treatment and until week 74 (p<0.001). Quality of life measured by DLQI score significantly increased during the treatment period (p<0.001). Drug survival of brodalumab treatment was 82.5%, and secondary failure (8.5%) was the main reason for treatment discontinuation. The occurrence of adverse events was low and restricted to non-severe infectious. Conclusion: This real-world data show that brodalumab is effective and safe for the treatment of moderate-to- severe psoriasis.