Brodalumab for the Treatment of Moderate-to-Severe Psoriasis: An Expert Delphi Consensus Statement

Maria Concetta Fargnoli^{1

2}, Federico Bardazzi³, Luca Bianchi^{4

5}, Paolo Dapavo⁶, Gabriella Fabbrocini⁷, Paolo Gisondi⁸, Giuseppe Micali⁹, Anna Maria Offidani¹⁰, Giovanni Pellacani¹¹, Nevena Skroza¹², Rosa Giuseppa Angileri¹³, Martina Burlando¹⁴, Anna Campanati¹⁵, Carlo Giovanni Carrera¹⁶, Andrea Chiricozzi^{17

18}, Andrea Conti¹⁹, Clara De Simone^{17

18}, Vito Di Lernia²⁰, Enzo Errichetti²¹, Marco Galluzzo^{4

5}, Claudio Guarneri²², Claudia Lasagni²³, Serena Lembo²⁴, Francesco Loconsole^{25

26}, Matteo Megna⁷, Maria Letizia Musumeci⁹, Francesca Prignano²⁷, Antonio Giovanni Richetta²⁸, Emanuele Trovato²⁹, Marina Venturini³⁰, Ketty Peris^{17

18}, Piergiacomo Calzavara Pinton³⁰

Affiliations

¹ Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
² Dermatology Unit, Ospedale San Salvatore, 67100 L'Aquila, Italy.
³ Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola Malpighi, 40126 Bologna, Italy.
⁴ Department of Systems Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy.
⁵ Dermatology Unit, Azienda Ospedaliera Universitaria "Policlinico Tor Vergata", 00133 Rome, Italy.
⁶ Dermatology Clinic, Department of Medical Sciences, University of Turin, 10124 Turin, Italy.
⁷ Section of Dermatology, Department of Clinical, Medicine and Surgery, University of Naples Federico II, 80138 Naples, Italy.
⁸ Section of Dermatology and Venereology, Department of Medicine, University of Verona, 37129 Verona, Italy.
⁹ Department of Dermatology, University of Catania, 95123 Catania, Italy.
¹⁰ Department of Clinical and Molecular Sciences, Dermatology Unit, Polytechnic Marche University, 60121 Ancona, Italy.
¹¹ Dermatology Clinic, Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza Medical School, Sapienza University of Rome, 00185 Rome, Italy.
¹² Dermatology Unit "D. Innocenzi", Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome-Polo Pontino, 04100 Latina, Italy.
¹³ UOC Dermatologia, ARNAS Civico Di Palermo, 90127 Palermo, Italy.
¹⁴ Clinica Dermatologica, DissaL, Ospedale Policlinico San Martino-IRCCS, 16132 Genova, Italy.
¹⁵ Department of Clinical and Molecular Sciences, Dermatology Clinic, Polytechnic Marche University, 60121 Ancona, Italy.
¹⁶ Dermatology Unit, Department of Internal Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
¹⁷ Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
¹⁸ UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, 00168 Rome, Italy.
¹⁹ Dermatologic Unit, Department of Surgery, Infermi Hospital, AUSL Romagna, 47923 Rimini, Italy.
²⁰ Dermatology Unit, Arcispedale S. Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy.
²¹ Institute of Dermatology, Azienda Sanitaria Universitaria Friuli Centrale (ASU FC), University of Udine, 33100 Udine, Italy.
²² Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98122 Messina, Italy.
²³ Clinica Dermatologica, Dipartimento delle Medicine Specialistiche AOU Policlinico di Modena, 41121 Modena, Italy.
²⁴ Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, 84084 Fisciano, Italy.
²⁵ Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, 70121 Bari, Italy.
²⁶ Azienda Ospedaliero Universitaria Consorziale Policlinico di Bari, 70124 Bari, Italy.
²⁷ Department of Health Sciences, Section of Dermatology, University of Florence, 50125 Florence, Italy.
²⁸ Unit of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, 00185 Rome, Italy.
²⁹ Section of Dermatology, Department of Medical, Surgical and Neurological Science, S. Maria alle Scotte Hospital, University of Siena, 53100 Siena, Italy.
³⁰ Dermatology Department, University of Brescia, 25121 Brescia, Italy.

PMID: 37240650
PMCID: PMC10219103
DOI: 10.3390/jcm12103545

Brodalumab for the Treatment of Moderate-to-Severe Psoriasis: An Expert Delphi Consensus Statement

Maria Concetta Fargnoli et al. J Clin Med. 2023.

. 2023 May 18;12(10):3545.

doi: 10.3390/jcm12103545.

Authors

Affiliations

¹ Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
² Dermatology Unit, Ospedale San Salvatore, 67100 L'Aquila, Italy.
³ Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola Malpighi, 40126 Bologna, Italy.
⁴ Department of Systems Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy.
⁵ Dermatology Unit, Azienda Ospedaliera Universitaria "Policlinico Tor Vergata", 00133 Rome, Italy.
⁶ Dermatology Clinic, Department of Medical Sciences, University of Turin, 10124 Turin, Italy.
⁷ Section of Dermatology, Department of Clinical, Medicine and Surgery, University of Naples Federico II, 80138 Naples, Italy.
⁸ Section of Dermatology and Venereology, Department of Medicine, University of Verona, 37129 Verona, Italy.
⁹ Department of Dermatology, University of Catania, 95123 Catania, Italy.
¹⁰ Department of Clinical and Molecular Sciences, Dermatology Unit, Polytechnic Marche University, 60121 Ancona, Italy.
¹¹ Dermatology Clinic, Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza Medical School, Sapienza University of Rome, 00185 Rome, Italy.
¹² Dermatology Unit "D. Innocenzi", Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome-Polo Pontino, 04100 Latina, Italy.
¹³ UOC Dermatologia, ARNAS Civico Di Palermo, 90127 Palermo, Italy.
¹⁴ Clinica Dermatologica, DissaL, Ospedale Policlinico San Martino-IRCCS, 16132 Genova, Italy.
¹⁵ Department of Clinical and Molecular Sciences, Dermatology Clinic, Polytechnic Marche University, 60121 Ancona, Italy.
¹⁶ Dermatology Unit, Department of Internal Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
¹⁷ Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
¹⁸ UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, 00168 Rome, Italy.
¹⁹ Dermatologic Unit, Department of Surgery, Infermi Hospital, AUSL Romagna, 47923 Rimini, Italy.
²⁰ Dermatology Unit, Arcispedale S. Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy.
²¹ Institute of Dermatology, Azienda Sanitaria Universitaria Friuli Centrale (ASU FC), University of Udine, 33100 Udine, Italy.
²² Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98122 Messina, Italy.
²³ Clinica Dermatologica, Dipartimento delle Medicine Specialistiche AOU Policlinico di Modena, 41121 Modena, Italy.
²⁴ Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, 84084 Fisciano, Italy.
²⁵ Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, 70121 Bari, Italy.
²⁶ Azienda Ospedaliero Universitaria Consorziale Policlinico di Bari, 70124 Bari, Italy.
²⁷ Department of Health Sciences, Section of Dermatology, University of Florence, 50125 Florence, Italy.
²⁸ Unit of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, 00185 Rome, Italy.
²⁹ Section of Dermatology, Department of Medical, Surgical and Neurological Science, S. Maria alle Scotte Hospital, University of Siena, 53100 Siena, Italy.
³⁰ Dermatology Department, University of Brescia, 25121 Brescia, Italy.

PMID: 37240650
PMCID: PMC10219103
DOI: 10.3390/jcm12103545

Abstract

Brodalumab is a recombinant, fully human immunoglobulin IgG2 monoclonal antibody specifically targeted against interleukin-17RA that has been approved for the treatment of moderate-to-severe psoriasis in Europe. We developed a Delphi consensus document focused on brodalumab for the treatment of moderate-to-severe psoriasis. Based on published literature and their clinical experience a steering committee drafted 17 statements covering 7 domains specific to the treatment of moderate-to-severe psoriasis with brodalumab. A panel of 32 Italian dermatologists indicated their level of agreement using a 5-point Likert scale (from 1 = "strongly disagree" to 5 = "strongly agree") using an online modified Delphi method. After the first round of voting (32 participants), positive consensus was reached for 15/17 (88.2%) of the proposed statements. Following a face-to-face virtual meeting, the steering committee decided that 5 statements would form "main principles" and 10 statements formed the final list. After a second round of voting, consensus was reached in 4/5 (80%) of the main principles and 8/10 (80%) for consensus statements. The final list of 5 main principles and 10 consensus statements identify key indications specific to the use of brodalumab in the treatment of moderate-to-severe psoriasis in Italy. These statements aid dermatologists in the management of patients with moderate-to-severe psoriasis.

Keywords: Delphi; brodalumab; consensus; psoriasis; statement.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1**
Main stages undertaken in the flow of the Consensus (SPARK) study.

**Figure 2**
Selection process for studies included in the literature search.

See this image and copyright information in PMC

References

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Brodalumab for the Treatment of Moderate-to-Severe Psoriasis: An Expert Delphi Consensus Statement

Affiliations

Brodalumab for the Treatment of Moderate-to-Severe Psoriasis: An Expert Delphi Consensus Statement

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Grants and funding

LinkOut - more resources

Full Text Sources