Brodalumab for Plaque Psoriasis in the Canadian Real-World Setting: A Retrospective Cohort Analysis of up to 4 Years.

INTRODUCTION

Psoriasis, a chronic inflammatory skin disease, affects approximately one million Canadians, with plaque psoriasis (PsO) being the most common subtype. While brodalumab has shown efficacy and safety in phase III clinical trials, Canadian real-world evidence remains limited. This retrospective cohort study aims to report on the real-world outcomes of Canadian patients with PsO who initiated treatment with brodalumab within the 4-year period following its approval by Health Canada.

METHODS

Data from patients with PsO initiating brodalumab treatment in the Canadian patient support program between July 1, 2018 and June 30, 2022 were analyzed. The primary objective evaluated the proportion of patients achieving a 100% reduction in the Psoriasis Area and Severity Index (PASI 100) at selected time windows. Secondary and exploratory objectives included assessing the 90% reduction in PASI score (PASI 90), changes from baseline in mean PASI, body surface area (BSA), and Dermatology Life Quality Index (DLQI) scores, as well as treatment persistence.

RESULTS

A total of 2482 patients (58.5% male; mean age 51.0 years) were included, with over half being biologic-naïve (56.9%). In a subset of patients with baseline and at least one follow-up data, 66.1% and 53.2% achieved PASI 90 and PASI 100, respectively, within the first 3 months. These rates were sustained, with 68.1% and 52.2% achieving PASI 90 and PASI 100, respectively, beyond 24 months. Significant improvements from baseline were observed for PASI, BSA, and DLQI scores, and these improvements were maintained over time. Among all patients, the 1-year persistence rate was 73.4%.

CONCLUSIONS

This study provides valuable insights into the profile of patients treated with brodalumab in Canada. While the rapid and sustained skin clearance, as well as improvements in PASI, BSA, and DLQI scores, support the therapeutic benefits of brodalumab beyond clinical trials, further research on long-term effectiveness and safety is warranted.