J Drugs Dermatol. 2023 Oct 1;22(10):SF378632s5-SF378632s15. doi: 10.36849/JDD.8632.
Psoriasis remains a highly prevalent condition in the United States and worldwide. Preclinical research has been triumphant in elucidating the critical immunological pathways involved in psoriasis. There has been an evolution in biologics that paralleled the understanding of these pathways beginning with anti-tumor necrosis factor (TNF) inhibitors and now most recently the interleukin (IL)-23 and IL-17 axes. Numerous evidence-based studies demonstrate the efficacy of these agents for skin clearance in moderate-to-severe plaque psoriasis. Brodalumab, a fully humanized IL-17 receptor A (IL-17RA) antagonist, is wholly unique in that it binds to a cytokine receptor and not a cytokine itself unlike the other biologics indicated for psoriasis. This unique mechanism has lent an advantage where not only is brodalumab effective in treating moderate-to-severe plaque psoriasis, but it is also successful in psoriasis patients whose disease did not respond to other biologics. This review provides a summary of the efficacy of brodalumab in plaque psoriasis and difficult-to-treat locations (ie, scalp, nail, palmoplantar), in patients with psoriasis who failed to achieve minimum clearance with other biologics, and it illuminates the most recent pharmacovigilance data obtained from the past 5 years. Furthermore, the cost effectiveness of brodalumab is also discussed. J Drugs Dermatol. 2023;22:10(Suppl 1):s5-14.
银屑病在美国和全球仍然是一种高度流行的疾病。临床前研究在阐明银屑病相关的关键免疫学途径方面取得了成功。生物制剂的发展与对这些途径的理解相平行,从抗肿瘤坏死因子(TNF)抑制剂开始,最近则是白细胞介素(IL)-23 和 IL-17 轴。大量基于证据的研究表明,这些药物在中重度斑块状银屑病的皮肤清除方面具有疗效。布罗达单抗是一种完全人源化的白细胞介素-17 受体 A(IL-17RA)拮抗剂,它完全不同于其他用于银屑病的生物制剂,因为它与细胞因子受体结合,而不是细胞因子本身。这种独特的机制具有优势,不仅布罗达单抗在治疗中重度斑块状银屑病方面有效,而且在其他生物制剂治疗无效的银屑病患者中也有效。本文综述了布罗达单抗在斑块状银屑病和难治性部位(如头皮、指甲、手掌和足底)中的疗效,以及在其他生物制剂治疗未能达到最小清除率的银屑病患者中的疗效,并阐明了过去 5 年获得的最新药物警戒数据。此外,还讨论了布罗达单抗的成本效益。J 皮肤病药物杂志。2023;22:10(增刊 1):s5-14。