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. 2021 Aug;11(4):1265-1275.
doi: 10.1007/s13555-021-00545-5. Epub 2021 May 14.

Dermatology Life Quality Index in Patients with Moderate-to-Severe Plaque Psoriasis Treated with Brodalumab or Ustekinumab

Jo Lambert  1 , Jes Birger Hansen  2 , Anne Sohrt  2 , Luis Puig  3
Affiliations

Dermatology Life Quality Index in Patients with Moderate-to-Severe Plaque Psoriasis Treated with Brodalumab or Ustekinumab

Jo Lambert et al. Dermatol Ther (Heidelb). 2021 Aug.

Abstract

Introduction: Targeted biological therapies for psoriasis have resulted in significant benefits, with therapeutic goals such as clear or almost clear skin accompanied by improvements in health-related quality of life (HRQoL). The objective of this study was to compare the effects of 52 weeks of treatment with brodalumab or ustekinumab on HRQoL in patients with moderate-to-severe plaque psoriasis.

Methods: Data were pooled from two randomised controlled phase 3 trials (AMAGINE-2 and -3) which included patients with moderate-to-severe plaque psoriasis treated with brodalumab 210 mg or ustekinumab 45 or 90 mg for 52 weeks. HRQoL outcomes were measured using the Dermatology Life Quality Index (DLQI) as well as the DLQI-Relevant (DLQI-R) version which excludes 'not relevant' responses.

Results: A total of 929 patients were included, 339 in the brodalumab group and 590 in the ustekinumab group. A significantly greater reduction (improvement) in DLQI score from baseline was observed in the brodalumab group compared with the ustekinumab group at weeks 4 [least-squares (LS) mean difference - 2.9, 95% confidence interval [CI] - 3.6 to - 2.2; p < 0.001), 12 (LS mean difference - 0.85, 95% CI - 1.5 to - 0.2; p = 0.01) and 52 (LS mean difference - 0.94, 95% CI - 1.6 to - 0.2; p = 0.009)]. Significantly greater proportions of patients treated with brodalumab achieved a DLQI score of 0 at weeks 4 (15.0 vs. 5.4%; p < 0.0001), 12 (37.5 vs. 28.0%; p = 0.0140) and 52 (46.3 vs. 30.3%; p < 0.0001), or of ≤ 1 [DLQI (0/1): 33.9 vs. 15.4%, 59.9 vs. 45.6% and 54.9 vs. 39.8%, respectively; all p < 0.0001]. Similar results were observed using the DLQI-R scoring system. Significantly more patients achieved a ≥ 4 or ≥ 5 improvement in DLQI with brodalumab compared to ustekinumab at weeks 4 and 52. Treatment with brodalumab was associated with significantly more patients achieving a DLQI of 0 compared to ustekinumab for all domains after 4 and 52 weeks.

Conclusion: Brodalumab was associated with a significantly greater improvement in HRQoL compared to ustekinumab in patients with moderate-to-severe psoriasis.

Keywords: Brodalumab; Pharmacology; Psoriasis; Quality of life; Ustekinumab.

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Figures

Fig. 1
Fig. 1
Proportions of patients achieving DLQI score of 0 (a) or 0/1 (b) or a DLQI-R score of 0/1 (c) per visit with brodalumab or ustekinumab (full analysis set, non-responder imputation). DLQI Dermatology Life Quality Index, DLQI-R adjusted DLQI correcting for bias in the ‘not relevant’ response (NRR), Q2W once every 2 weeks
Fig. 2
Fig. 2
The AUC for DLQI score 0/1 with brodalumab or ustekinumab. AUC = 100% would mean 100% of patients achieve and maintain DLQI 0/1 from week 0 to week 52 (ideal response). AUC Area-under-the-curve
Fig. 3
Fig. 3
Patients achieving an improvement in DLQI of ≥ 4 points with brodalumab and ustekinumab at 4, 12 and 52 weeks (full analysis set, non-responder imputation). CI Confidence interval, OR odds ratio
Fig. 4
Fig. 4
Patients achieving DLQI 0 for individual domains with brodalumab and ustekinumab at 4, 12 and 52 weeks (full analysis set, non-responder imputation)
See this image and copyright information in PMC

References

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