Plaque psoriasis: brodalumab bests most other biologics in meta-analysis

  • Xue W & al.
  • J Cutan Med Surg
  • 26 Jun 2020

  • curated by Brian Richardson, PhD
  • Clinical Essentials
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Takeaway

  • Brodalumab is associated with superior efficacy for moderate to severe plaque psoriasis compared with etanercept, adalimumab, ustekinumab, secukinumab, and guselkumab, according to a network meta-analysis from Canada.

Why this matters

  • Many new biologic therapies have recently become available for treatment of psoriasis, but head-to-head trials are lacking.

Key results

  • Brodalumab 210 mg was associated with superior efficacy (rate of 100% improvement in the Psoriasis Area and Severity Index [PASI 100]) compared with (relative risks; 95% credible intervals):
    • Placebo: 496.1 (332.1-768.5).
    • Ustekinumab 45 mg: 2.29 (1.86-2.88).
    • Ustekinumab 90 mg: 1.85 (1.45-2.48).
    • Secukinumab 300 mg: 1.41 (1.1-1.87).
    • Etanercept 50 mg: 5.43 (4.08-7.51).
    • Adalimumab 80 mg/40 mg: 3.48 (2.52-5). 
    • Guselkumab 100 mg: 1.48 (1.09-2.08).
      • Results were not statistically significant for infliximab 5 mg/kg (1.24; 0.93-1.7) or ixekizumab 160 mg/80 mg (0.97; 0.79-1.23).
  • Similar results were observed for PASI 75 and PASI 90.

Study design

  • 43 randomized controlled trials were included in the meta-analysis.
  • Funding: Bausch Health, Canada Inc. (manufacturer of brodalumab).

Limitations

  • No comparison of safety data.