The use of brodalumab for psoriatic arthritis resulted in a
substantial improvement in skin condition and brought about a reduction in
dactylitis, a condition that features the swelling of the fingers and toes and
is commonly found in psoriatic arthritis patients, according to the study's
lead researcher, Dr. Philip Mease, a rheumatologist at Swedish Medical Center
Psoriatic arthritis is a chronic inflammatory disease of the skin
and joints and affects as many as 30% of people who suffer from psoriasis.
Psoriasis causes raised, scaly red and white patches on the
skin. Psoriasis often affects the tips
of elbows and knees, the scalp, the navel, the ears and around the genital
areas or anus. In the case of psoriatic
arthritis, the joints are affected as well, resulting in inflammation. Prolonged inflammation can result in joint
damage, according to the American College of Rheumatology (ACR).
As in psoriasis, symptoms in psoriatic arthritis also come and go
and vary from person to person. They
even change locations over a period of time.
Brodalumab falls under a category of drugs called IL-17 inhibitors. IL-17 inhibitors block a signaling pathway
that plays a vital role in triggering and developing inflammatory diseases.
A 68-patient trial of the biotech drug, brodalumab, was conducted and a
12-week data presented by Amben and its partner AstraZeneca Plc. The data showed the relative superiority of
the drug over a placebo in terms of efficacy.
The patients were classified under 3 groups:
Those who got 140 milligrams of brodalumab every two weeks, those who received
280 milligrams of the drug and those who received the placebo. At the end of the 12 weeks, patients from
all the 3 groups were given the maximum dose over a span of the next 40 weeks. A significant improvement in the disease condition was noticed at the end of
Findings at the end of 52 weeks showed 71 percent of patients who from the
start received the 140 mg dose, 56 percent of patients who received 280 mg from
the beginning and 50 percent of the original placebo group had hit ACR20.
Findings at 12 weeks showed 37 percent of the minimum-dose group and 39
percent of the high-dose group had reached the goal of ACR20, whereas only 18
percent of the placebo group had hit the target.
ACR20 is a unit of measurement that signifies at least 20 percent
improvement in signs and symptoms of psoriatic arthritis.
ACR50 indicates a 50 percent progress in disease signs and symptoms. This goal was reached by 47 percent of the
original 140-mg patients and 27 percent of the original 280-mg patients at a year.
ACR70 was achieved by 22 percent of the first group and 7 percent of the
Of the placebo group, those who switched to 280 mg, the ACR50 rate was 38
percent and ACR70, 14 percent.
Research firm ISI Group has predicted annual peak sales of about $2 billion
for the drug.
Patients involved in the study suffered from psoriasis in varied degrees,
and they had failed at least one therapy.
About one half of them had stopped responding to injectable biologic
medicines known as anti-TNF drugs, including Humira and Enbrel as the efficacy
of anti-TNF drugs tends to diminish over a period of time.
"It's hopeful that this (anti-IL-17) mechanism is central enough that
they're going to have responses despite the failure of anti-TNF therapy,"
Four cases of serious adverse events were reported, that included one
patient who was severely infected and another one with complaint of abdominal
pain, but no deaths were reported.
Mease, the study's lead researcher, also noted that psoriatic
arthritis is a genetic disorder that distinguishes it from other types of
"There are also certain genes that are present in people who
develop the arthritis that are not present in people with psoriasis. So there
seems to be a heavy genetic component for determining who gets psoriasis and
goes on to get psoriatic arthritis," he said.
At present, psoriatic arthritis is treated based on the degree of
pain experienced by the patient. The
treatment begins with painkillers, such as ibuprofen or naproxen..
Mease said methotrexate is given to treat patients suffering from
both arthritis and psoriasis. Other
drugs included in the biologic therapy that are helpful in treating both
conditions are adalimumab, etanercept, golimumab and infliximab.
Findings of the study were published June 12 in the New
England Journal of Medicine.
They will be presented at the European
Congress of Rheumatology's annual meeting in Paris on Thursday.