Brodalumab, an anti-interleukin-17-receptor antibody for psoriasis.
Author(s): Papp KA, Leonardi C, Menter A, Ortonne JP, Krueger JG, Kricorian G, Aras G, Li J,
Russell CB, Thompson EH, Baumgartner S.
Affiliation(s): Probity Medical Research, Waterloo, ON, Canada. kapapp@probitymedical.com
Publication date & source: 2012, N Engl J Med. , 366(13):1181-9
BACKGROUND: In this phase 2, randomized, double-blind, placebo-controlled,
dose-ranging study, we assessed the efficacy and safety of brodalumab (AMG 827),
a human anti-interleukin-17-receptor monoclonal antibody, for the treatment of
moderate-to-severe plaque psoriasis.
METHODS: We randomly assigned patients with a score of 12 or higher on the
psoriasis area-and-severity index (PASI, on which scores range from 0 to 72, with
higher scores indicating more severe disease) and with 10% or more of their
body-surface area affected by psoriasis to receive brodalumab (70 mg, 140 mg, or
210 mg at day 1 and weeks 1, 2, 4, 6, 8, and 10 or 280 mg monthly) or placebo.
The primary end point was the percentage improvement from baseline in the PASI
score at week 12. Secondary end points included improvement of at least 75% and
at least 90% in the PASI score and the score on the static physician's global
assessment at week 12.
RESULTS: A total of 198 patients underwent randomization. At week 12, the mean
percentage improvements in the PASI score were 45.0% among patients receiving 70
mg of brodalumab, 85.9% among those receiving 140 mg, 86.3% among those receiving
210 mg, 76.0% among those receiving 280 mg, and 16.0% among those receiving
placebo (P<0.001 for all comparisons with placebo). An improvement of at least
75% and at least 90% in the PASI score at week 12 was seen in 77% and 72%,
respectively, of the patients in the 140-mg brodalumab group and in 82% and 75%,
respectively, of the patients in the 210-mg group, as compared with 0% in the
placebo group (P<0.001 for all comparisons). The percentage of patients with a
static physician's global assessment of clear or minimal disease was 26%, 85%,
80%, and 69% with the 70-mg, 140-mg, 210-mg, and 280-mg doses, respectively, of
brodalumab, as compared with 3% with placebo (P<0.01 for all comparisons with
placebo). Two cases of grade 3 neutropenia were reported in the 210-mg brodalumab
group. The most commonly reported adverse events in the combined brodalumab
groups were nasopharyngitis (8%), upper respiratory tract infection (8%), and
injection-site erythema (6%).
CONCLUSIONS: Brodalumab significantly improved plaque psoriasis in this 12-week,
phase 2 study. (Funded by Amgen; ClinicalTrials.gov number, NCT00975637.).
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