Highlights from

SPIN 2019

Skin Inflammation & Psoriasis International Network

Paris 25-27 April 2019

Brodalumab onset of action is significantly faster than ustekinumab: Results from the phase 3 AMAGINE-2 and -3 studies

Treating psoriasis patients with brodalumab achieves complete skin clearance more rapidly than ustekinumab. Dr Sandra Philipp (Charité-Universitätsmedizin Berlin, Germany) began by pointing out that although efficacy is obviously important, patients rate the speed at which their disease improves as their most important treatment goal [1]. In the phase 3 AMAGINE-2 and AMAGINE-3 trials, Lebwohl et al. set out to describe and compare the onset of action, measured as the improvements in efficacy and quality of life, of brodalumab and ustekinumab in patients with moderate-to-severe psoriasis [2]. This pooled analysis included data from patients who were randomised to constant ustekinumab (n=590) or brodalumab (n=339) 210 mg every 2 weeks. Efficacy was measured at number of patients with 75% or 100% improvement in the psoriasis area severity index (PASI) score, the attainments of an absolute PASI score of 2 or less, and achievement of a Dermatology Life Quality Index of 0 or 1.

Patients treated with brodalumab had a far more rapid response and a significantly higher proportion achieved PASI-75 already at week 2 compared with ustekinumab (OR:8.5, P<0.001). Even more impressive, was that patients treated with brodalumab had a >15 higher chance of achieving complete skin clearance (PASI-100) already after 4 weeks of treatment compared with ustekinumab (OR:15.6, P<0.001). This trend still holds true at week 12, at which point twice as many patients have achieved PASI-100. The take-home message was that both drugs may be clinically effective, but the greatest difference between the treatments is at the earlier timepoints; particularly for complete clearance at week 4. These results confirm the significantly faster onset of action with brodalumab compared with ustekinumab in both clinical efficacy as well as patient-reported outcome measures.

  1. Philipp S, et al. Immediate onset of action of brodalumab compared with ustekinumab: Results from the phase 3 AMAGINE-2 and -3 studies. P006, SPIN 2019, 25-27 April, Paris, France.
  2. Lebwohl MG, et al. Phase 3 Studies Comparing Brodalumab with Ustekinumab in Psoriasis. N Engl J Med. 2015 Oct;373(14):1318-28.

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