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The effect of subcutaneous brodalumab on clinical disease activity in hidradenitis suppurativa: An open-label cohort study - 10/10/20

Doi : 10.1016/j.jaad.2020.05.007 
John W. Frew, MBBS a, Kristina Navrazhina, BA a, b, David Grand, BA a, c, Mary Sullivan-Whalen, FNP a, Patricia Gilleaudeau, FNP a, Sandra Garcet, PhD a, Jonathan Ungar, MD d, James G. Krueger, MD, PhD a,
a Laboratory of Investigative Dermatology, The Rockefeller University, New York, New York 
b Weill Cornell/Rockefeller/Sloan Kettering Tri-institutional MD-PhD Program, Weill Cornell Medicine, New York, New York 
c Albert Einstein College of Medicine, Bronx, New York 
d Icahn School of Medicine at Mount Sinai, New York, New York 

Correspondence to: James G. Krueger, MD, PhD, Laboratory of Investigative Dermatology, Rockefeller University, 1230 York Ave, New York, NY 10065.Laboratory of Investigative DermatologyRockefeller University1230 York AveNew YorkNY10065

Abstract

Background

Hidradenitis suppurativa is an autoinflammatory disorder of keratinization, with dysregulation of T helper type 17 cytokines. Brodalumab is a monoclonal antibody that targets the interleukin (IL) 17 receptor A receptor.

Objectives

To assess the safety and tolerability and clinical response at weeks 12 and 24 of brodalumab in moderate to severe HS. Ten participants with no history of inflammatory bowel disease were administered brodalumab 210 mg/1.5 mL subcutaneously at weeks 0, 1, and 2 and every 2 weeks thereafter until week 24. Participants were assessed for adverse events (grade 2/3 adverse events) and clinical response (Hidradenitis Suppurativa Clinical Response [HiSCR], Sartorius, International Hidradenitis Suppurativa Severity Scoring System [IHS4]), including ultrasonography and skin biopsies.

Results

All 10 participants completed the study. No grade 2/3 adverse events associated with the use of brodalumab were reported. All patients (100%) achieved HiSCR, and 80% achieved IHS4 category change at week 12. HiSCR achievement occurred as early as week 2, likely due to the unique blockade of IL-17A, IL-17C, and IL-17F by brodalumab. Significant improvements were seen in pain, itch, quality of life, and depression.

Conclusions

Brodalumab was well tolerated in this HS cohort, with no serious adverse events and improvement in clinical outcomes. Alterations in dose frequency may be required in those with advanced disease, which requires further exploration.

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Graphical abstract




Le texte complet de cet article est disponible en PDF.

Key words : acne inversa, biologics, brodalumab, cohort study, hidradenitis suppurativa, IL-17A, IL-17C, IL-17F, IL-17RA, monoclonal therapeutics, open label, Th17, translational medicine

Abbreviations used : AN, BDI, DLQI, HiSCR, HS, IHS4, IL, IL-17R, Th


Plan


 Funding sources: Dr Frew was supported in part by grant UL1 TR001866 from the National Center for Advancing Translational Sciences, National Institutes of Health (NIH) Clinical and Translational Science Award program. Author Navrazhina was supported by a Medical Scientist Training Program grant from the National Institute of General Medical Sciences of the NIH under award number T32GM007739 to the Weill Cornell/Rockefeller/Sloan Kettering Tri-institutional MD-PhD Program.
 Disclosure: Dr Krueger has received research support (grants paid to institution) from AbbVie, Amgen, Bristol Myers Squibb, Boehringer, EMD Serono, Innovaderm, Kineta, LEO Pharma, Novan, Novartis, Paraxel, Pfizer, Regeneron, and Vitae and personal fees from AbbVie, Acros, Allergan, Aurigne, BiogenIdec, Boehringer, Escalier, Janssen, Lilly, Novartis, Pfizer, Roche, and Valeant. Dr Frew; Authors Navrazhina, Grand, Sullivan-Whalen, and Gilleaudeau; and Drs Garcet and Ungar have no conflicts of interest to declare.
 IRB approval status: Reviewed and approved by Rockefeller University Institutional Review Board.


© 2020  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 83 - N° 5

P. 1341-1348 - novembre 2020 Retour au numéro
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