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Efficacy and Safety of Brodalumab in Patients with Moderate-to-Severe Plaque Psoriasis and Skin of Color: Results from the Pooled AMAGINE-2/-3 Randomized Trials.
Am J Clin Dermatol. 2019 Apr; 20(2):267-276.AJ

Abstract

BACKGROUND

Data on treatment outcomes in patients with psoriasis who have skin of color are limited. Brodalumab has shown efficacy in patients with moderate-to-severe plaque psoriasis.

OBJECTIVE

Our objective was to evaluate the efficacy, safety, and health-related quality of life associated with brodalumab in patients with skin of color participating in two phase III, multicenter, randomized, double-blind, placebo- and active comparator-controlled studies (AMAGINE-2/-3).

METHODS

Patients were self-categorized into racial subgroups (black, Asian, or white) or the non-mutually exclusive ethnic subgroup Hispanic/Latino. Patients were randomized to receive brodalumab 210 mg every 2 weeks (Q2W) or ustekinumab (45 mg in patients weighing ≤ 100 kg and 90 mg in patients weighing > 100 kg) for 52 weeks. Skin clearance was monitored using the Psoriasis Area and Severity Index (PASI) and Static Physician's Global Assessment (sPGA). Treatment-emergent adverse events (TEAEs) were summarized by treatment and racial and ethnic subgroup. Health-related quality of life was assessed using the Dermatology Life Quality Index (DLQI).

RESULTS

During the 12-week induction phase, 613 patients received ustekinumab (black, n = 20; Asian, n = 24; white, n = 551; Hispanic/Latino, n = 68) and 1236 patients received brodalumab 210 mg Q2W (black, n = 36; Asian, n = 39; white, n = 1116; Hispanic/Latino, n = 132). At week 52, a total of 590 patients received continuous ustekinumab (black, n = 19; Asian, n = 23; white, n = 532; Hispanic/Latino, n = 64) and 339 patients were re-randomized to continue receiving brodalumab 210 mg Q2W (black, n = 10; Asian, n = 7; white, n = 308; Hispanic/Latino, n = 40). Among patients who received brodalumab 210 mg Q2W, skin clearance response rates were similar across racial and ethnic subgroups at week 12 and week 52; rates of 75%, 90%, and 100% improvement in PASI from baseline were also higher, as was sPGA score ≤ 1, than in patients who received ustekinumab across all racial and ethnic subgroups. Rates of TEAEs and ≥ 5-point improvement in DLQI score were similar across racial and ethnic subgroups.

CONCLUSIONS

Brodalumab 210 mg Q2W is well tolerated and efficacious across diverse racial and ethnic subgroups in patients with psoriasis, including black, Asian, white, and Hispanic/Latino patients.

TRIAL REGISTRY

ClinicalTrials.gov identifier NCT01708603 (AMAGINE-2); NCT01708629 (AMAGINE-3).

Authors+Show Affiliations

Department of Dermatology, Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-Salem, NC, 27104, USA. amcmicha@wakehealth.edu.Innovative Dermatology, Plano, TX, USA. University of Texas Southwestern Medical Center, Dallas, TX, USA.Ortho Dermatologics, Bridgewater, NJ, USA.Ortho Dermatologics, Bridgewater, NJ, USA.Mount Sinai St. Luke's and Mount Sinai West, New York, NY, USA.

Pub Type(s)

Comparative Study
Journal Article
Meta-Analysis

Language

eng

PubMed ID

30471012

Citation

McMichael, Amy, et al. "Efficacy and Safety of Brodalumab in Patients With Moderate-to-Severe Plaque Psoriasis and Skin of Color: Results From the Pooled AMAGINE-2/-3 Randomized Trials." American Journal of Clinical Dermatology, vol. 20, no. 2, 2019, pp. 267-276.
McMichael A, Desai SR, Qureshi A, et al. Efficacy and Safety of Brodalumab in Patients with Moderate-to-Severe Plaque Psoriasis and Skin of Color: Results from the Pooled AMAGINE-2/-3 Randomized Trials. Am J Clin Dermatol. 2019;20(2):267-276.
McMichael, A., Desai, S. R., Qureshi, A., Rastogi, S., & Alexis, A. F. (2019). Efficacy and Safety of Brodalumab in Patients with Moderate-to-Severe Plaque Psoriasis and Skin of Color: Results from the Pooled AMAGINE-2/-3 Randomized Trials. American Journal of Clinical Dermatology, 20(2), 267-276. https://doi.org/10.1007/s40257-018-0408-z
McMichael A, et al. Efficacy and Safety of Brodalumab in Patients With Moderate-to-Severe Plaque Psoriasis and Skin of Color: Results From the Pooled AMAGINE-2/-3 Randomized Trials. Am J Clin Dermatol. 2019;20(2):267-276. PubMed PMID: 30471012.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy and Safety of Brodalumab in Patients with Moderate-to-Severe Plaque Psoriasis and Skin of Color: Results from the Pooled AMAGINE-2/-3 Randomized Trials. AU - McMichael,Amy, AU - Desai,Seemal R, AU - Qureshi,Aamir, AU - Rastogi,Shipra, AU - Alexis,Andrew F, PY - 2018/11/25/pubmed PY - 2019/8/1/medline PY - 2018/11/25/entrez SP - 267 EP - 276 JF - American journal of clinical dermatology JO - Am J Clin Dermatol VL - 20 IS - 2 N2 - BACKGROUND: Data on treatment outcomes in patients with psoriasis who have skin of color are limited. Brodalumab has shown efficacy in patients with moderate-to-severe plaque psoriasis. OBJECTIVE: Our objective was to evaluate the efficacy, safety, and health-related quality of life associated with brodalumab in patients with skin of color participating in two phase III, multicenter, randomized, double-blind, placebo- and active comparator-controlled studies (AMAGINE-2/-3). METHODS: Patients were self-categorized into racial subgroups (black, Asian, or white) or the non-mutually exclusive ethnic subgroup Hispanic/Latino. Patients were randomized to receive brodalumab 210 mg every 2 weeks (Q2W) or ustekinumab (45 mg in patients weighing ≤ 100 kg and 90 mg in patients weighing > 100 kg) for 52 weeks. Skin clearance was monitored using the Psoriasis Area and Severity Index (PASI) and Static Physician's Global Assessment (sPGA). Treatment-emergent adverse events (TEAEs) were summarized by treatment and racial and ethnic subgroup. Health-related quality of life was assessed using the Dermatology Life Quality Index (DLQI). RESULTS: During the 12-week induction phase, 613 patients received ustekinumab (black, n = 20; Asian, n = 24; white, n = 551; Hispanic/Latino, n = 68) and 1236 patients received brodalumab 210 mg Q2W (black, n = 36; Asian, n = 39; white, n = 1116; Hispanic/Latino, n = 132). At week 52, a total of 590 patients received continuous ustekinumab (black, n = 19; Asian, n = 23; white, n = 532; Hispanic/Latino, n = 64) and 339 patients were re-randomized to continue receiving brodalumab 210 mg Q2W (black, n = 10; Asian, n = 7; white, n = 308; Hispanic/Latino, n = 40). Among patients who received brodalumab 210 mg Q2W, skin clearance response rates were similar across racial and ethnic subgroups at week 12 and week 52; rates of 75%, 90%, and 100% improvement in PASI from baseline were also higher, as was sPGA score ≤ 1, than in patients who received ustekinumab across all racial and ethnic subgroups. Rates of TEAEs and ≥ 5-point improvement in DLQI score were similar across racial and ethnic subgroups. CONCLUSIONS: Brodalumab 210 mg Q2W is well tolerated and efficacious across diverse racial and ethnic subgroups in patients with psoriasis, including black, Asian, white, and Hispanic/Latino patients. TRIAL REGISTRY: ClinicalTrials.gov identifier NCT01708603 (AMAGINE-2); NCT01708629 (AMAGINE-3). SN - 1179-1888 UR - https://www.unboundmedicine.com/medline/citation/30471012/Efficacy_and_Safety_of_Brodalumab_in_Patients_with_Moderate_to_Severe_Plaque_Psoriasis_and_Skin_of_Color:_Results_from_the_Pooled_AMAGINE_2/_3_Randomized_Trials_ DB - PRIME DP - Unbound Medicine ER -