P71: Demographics and drug survival in patients with psoriasis treated with brodalumab enrolled in the British Association of Dermatologists Biologic and Immunomodulators Register (BADBIR) up to 1 year

J. Birger Hansen,¹ E. Didriksen Apol,¹ M. Sheikh,² K. Vadstrup¹ and A. Martin-Clavijo³

¹LEO Pharma A/S, Ballerup, Denmark; ²LEO Pharma A/S, Hurley, UK; and ³University Hospital Birmingham (UHB), Birmingham, UK

Real-world evidence on the therapeutic success of biologics in psoriasis can support clinical decision-making. Evidence on patient characteristics and the therapeutic success of brodalumab in everyday clinical practice is currently limited. The objective of the present study was to describe the demographics, disease severity and comorbidities, and to estimate drug survival, of patients with psoriasis treated with brodalumab included in the British Association of Dermatologists Biologic and Immunomodulators Register (BADBIR). This analysis included patients initiated on brodalumab in BADBIR from 19 January 2018 to 30 October 2020. Drug survival analysis was conducted by Kaplan–Meier estimation. Windowing analyses of Psoriasis Area and Severity Index (PASI), Physician's Global Assessment and Dermatology Life Quality Index (DLQI) for baseline and 12 months after the start of treatment was conducted as observed. In total, 213 adult patients receiving treatment with brodalumab for moderate-to-severe plaque psoriasis were included in this analysis. Patients were predominantly male (59·2%), mean age was 23·5 years, mean body mass index (BMI) was 33·0, and mean baseline PASI and DLQI were 13·0 (n = 127) and 16·5 (n = 76), respectively. In total, 157 patients (73·7%) had at least one comorbidity, the most common being hypertension (27·2%), depression (26·3%), diabetes (11·7%) and psoriatic arthropathy (PsA; 6·1%). Fifty patients (23·5%) were biologic-naïve, 101 (47·4%) started brodalumab without a specified previous biologic and 62 (29·1%) were biologic-experienced with a known previous biologic. The predicted drug survival probability at 12 months for all patients was 85·2% [95% confidence interval (CI) 79·6–91·1]. At 12 months, biologic-naïve patients and patients with previous biologic use had similar drug survival [86·2% (95% CI 75·3–98·6) and 85·0% (95% CI 78·8-91·7), respectively]; elderly patients (those aged ≥ 65 years) had lower drug survival (79·5%, 95% CI 59·3–100) than those aged < 65 years (85·6%, 95% CI 79·9–91·8); patients with a BMI < 30 and ≥ 30 at baseline had similar drug survival [85·2% (95% CI 76·0–95·5) and 84·2% (95% CI 77·1–91·9), respectively]. PsA did not seem to affect drug survival [PsA: 83·8% (95% CI 70·2–100·0); no PsA: 85·3% (95% CI 79·3–91·8)]. Thirty patients (14·1%) stopped owing to lack of efficacy or adverse events (n = 13). At 12 months, 54 patients reported an absolute PASI score ≤ 2, and 33 an DLQI score of 0 or 1. This analysis indicates high and sustained drug survival rates for brodalumab after 1 year of treatment, irrespective of patient subgroup, as well as high rates of clearance in a real-world clinical setting. Further real-world studies are warranted to study the longer-term effectiveness of brodalumab.

Funding sources: this study was funded by LEO Pharma A/S, Ballerup, Denmark.