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Immunogenicity and skin clearance recapture in clinical studies of brodalumab - 09/01/20

Doi : 10.1016/j.jaad.2019.05.094 
Jerry Bagel, MD a, , Mark Lebwohl, MD b, Robert J. Israel, MD c, Abby Jacobson, PA-C d
a Psoriasis Treatment Center of Central New Jersey, East Windsor, New Jersey 
b Icahn School of Medicine at Mount Sinai, New York, New York 
c Bausch Health, Bridgewater, New Jersey 
d Ortho Dermatologics, Bridgewater, New Jersey 

Correspondence to: Jerry Bagel, MD, Psoriasis Treatment Center of Central New Jersey, 59 One Mile Rd Extension, East Windsor, NJ 08520.Psoriasis Treatment Center of Central New Jersey59 One Mile Rd ExtensionEast WindsorNJ08520

Abstract

Background

Antidrug antibodies (ADAs) may change pharmacokinetic or pharmacodynamic profiles of biologic therapies, potentially decreasing efficacy.

Objective

To evaluate the potential effects of brodalumab immunogenicity on safety, efficacy, and retreatment.

Methods

Data from 1 phase 2 and 3 phase 3 studies of brodalumab in psoriasis were analyzed.

Results

Overall, 2.7% of patients had positive test results for binding ADAs after receiving brodalumab; ADAs were transient in 1.4% of patients, and there were no neutralizing ADAs. Among ADA-positive patients, 60.0% (3/5) achieved a static physician's global assessment score of 0 or 1 at week 12 in the group receiving the brodalumab 210 mg every 2 weeks, compared with 79.1% (1131/1429) of ADA-negative patients. All patients (100%) who experienced return of disease and were retreated with brodalumab 210 mg every 2 weeks (none were ADA positive) achieved at least a 75% improvement in Psoriasis Area And Severity Index, ≥90% of whom regained response by week 8 of retreatment. Hypersensitivity reactions were less frequent with brodalumab than with placebo. Injection site reactions occurred in 1.8% of patients treated with brodalumab versus 2% of patients treated with ustekinumab.

Limitations

Retreatment could be assessed in only 1 phase 3 brodalumab study.

Conclusion

Brodalumab compares favorably with other biologics in terms of immunogenicity and high rates of efficacy recapture upon retreatment.

Il testo completo di questo articolo è disponibile in PDF.

Key words : antidrug antibody, brodalumab, immunogenicity, psoriasis

Abbreviations used : ADA, AE, IL, mAb, PASI, PASI 75, PASI 90, PASI 100, sPGA


Mappa


 Funding sources: Supported by Ortho Dermatologics.
 Disclosure: Dr Bagel is a speaker and investigator for AbbVie, Celgene, Eli Lilly, Janssen, Novartis, and Ortho Dermatologics and an investigator for Amgen, Boehringer Ingelheim, Bristol-Myers Squibb, and LEO Pharma. Dr Lebwohl is an employee of Mount Sinai, which receives research funds from AbbVie, Boehringer Ingelheim, Celgene, Eli Lilly, Incyte, Janssen/Johnson & Johnson, LEO Pharma, MedImmune/AstraZeneca, Novartis, Pfizer, SCIderm, UCB, Valeant, and Vidac Pharma and is also a consultant for Allergan, Aqua, Arcutis, Boehringer Ingelheim, LEO Pharma, Menlo, Promius, and Verrica. Dr Israel is an employee of Bausch Health and holds stock and/or stock options in the company. Dr Jacobson is an employee of Ortho Dermatologics and holds stock and/or stock options in Bausch Health.
 Reprints not available from the authors.


© 2019  American Academy of Dermatology, Inc.. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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Vol 82 - N° 2

P. 344-351 - febbraio 2020 Ritorno al numero
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