Experimental Treatment for Psoriasis Shows Promise

Psoriasis treatment brodalumab more effective than standard treatment in clinical trials

/ Author:  / Reviewed by: Beth Bolt, RPh

(RxWiki News) A promising new drug to help psoriasis patients control their itchy, frustrating outbreaks may soon be on the way.

In two phase III clinical trials, researchers from Mount Sinai School of Medicine found that an experimental treatment for psoriasis called brodalumab may be more effective than the commonly-used psoriasis treatment ustekinumab (brand name Stelara).

Psoriasis is a chronic skin condition that changes the life cycle of skin cells, causing them to build up rapidly on the skin's surface. These extra skin cells form thick scales and itchy, dry patches that can be painful.

The primary goal of psoriasis treatment is to stop skin cells from growing too quickly. While there is no cure, treatments may offer significant relief for patients with this condition.

Brodalumab is what's known as a monoclonal antibody. When this antibody attaches to a cell, it makes the cell more visible to the immune system — the immune system attacks foreign invaders in the body, but it doesn't always recognize its own cells as enemies.

Brodalumab was designed to block the immune system's signaling of a protein called IL-17. If not blocked, IL-17 contributes to abnormal inflammation in the skin cells.

"Brodalumab is the only IL-17 receptor antagonist in clinical development," said lead study author Mark Lebwohl, MD, in a press release. "[Our] results are better than any previously published and confirm that targeting the IL-17 receptor is highly effective in the treatment of moderate to severe plaque psoriasis. Treatment was so effective that many patients did not have a dot of psoriasis left on their bodies."

Dr. Lebwohl is the chairman of the Department of Dermatology at Mount Sinai School of Medicine.

For these studies, Dr. Lebwohl and team looked at 3,712 patients with moderate to severe psoriasis. These patients were given either brodalumab, Stelara or a placebo for 12 weeks.

At week 12, the patients on brodalumab were randomly assigned to receive a brodalumab maintenance dose of 210mg every two weeks, or 140mg every two, four or eight weeks.

The patients on Stelara continued to receive Stelara every 12 weeks, while the patients on placebo received 210 mg of brodalumab every two weeks.

Psoriasis treatment effectiveness is often graded using the Psoriasis Area Severity Index (PASI), which scores redness, scaling and thickness of patches, and the extent of the body involved, on a scale of 1 to 100. A 100 percent reduction in psoriasis symptoms is therefore known as a PASI 100.

After 12 weeks, 44 percent of the patients in the first study who received 210mg of brodalumab every other week achieved PASI 100. By comparison, 22 percent of the patients on Stelara achieved the same.

In the second study, 37 percent of the patients who received 210mg of brodalumab every other week achieved PASI 100 compared to 19 percent of the patients on Stelara.

With the higher dose of brodalumab, 86 percent of patients also achieved PASI 75 (a 75 percent reduction in symptoms).

This study was published Sept. 30 in the New England Journal of Medicine.

Amgen and AstraZeneca funded this research. These companies make medications used in the treatment of psoriasis.

No conflicts of interest were disclosed.

Reviewed by: 
Review Date: 
October 1, 2015
Last Updated:
October 5, 2015