Effectiveness of Brodalumab for the Treatment of Moderate-to-Severe Psoriasis: A Retrospective, Real-World Multicenter Study with a Focus on Obese and Multi-Failure Patients-IL PSO (Italian Landscape Psoriasis)

Diego Orsini¹, Dario Graceffa¹, Martina Burlando^{2

3}, Anna Campanati⁴, Elena Campione⁵, Claudio Guarneri⁶, Alessandra Narcisi⁷, Paolo Pella⁸, Paolo Romita⁹, Massimo Travaglini¹⁰, Leonardo Zichichi¹¹, Luisa Maria Halina Arancio¹², Ginevra Baggini¹³, Riccardo Balestri¹⁴, Tommaso Bianchelli⁴, Luca Bianchi⁵, Alexandra Maria Giovanna Brunasso¹⁵, Anna Elisabetta Cagni¹⁶, Giacomo Caldarola^{17

18}, Gianluca Calianno⁹, Anton Carpentieri¹⁰, Martino Carriero¹⁹, Andrea Carugno²⁰, Franco Cona²¹, Antonio Costanzo⁷, Emanuele Claudio Cozzani^{2

3}, Giacomo Dal Bello²², Giovanni Carlo Lazzaro Danzuso²³, Annunziata Dattola²⁴, Marianna Donnarumma²⁵, Elena De Col²⁶, Maria Esposito²⁷, Carmen Silvia Fiorella²⁸, Marco Galluzzo⁵, Francesca Graziola²⁹, Gaetano Licata¹¹, Matteo Licciardello³⁰, Agostina Legori³¹, Piergiorgio Malagoli³², Federica Mola³³, Gaia Moretta³⁴, Andrea Muracchioli³⁵, Attilia Musumeci³⁶, Maria Letizia Musumeci³⁷, Gianluca Pagnanelli³⁴, Vincenzo Panasiti³⁸, Lucia Peterle⁶, Eugenio Provenzano³⁹, Marco Rubatto⁴⁰, Oriele Sarno⁴¹, Davide Strippoli⁴², Fabrizio Vaira⁴³, Maria Concetta Fargnoli¹

Affiliations

¹ San Gallicano Dermatological Institute (IRCCS), 00144 Rome, Italy.
² Section of Dermatology, Department of Health Sciences (DiSSal), University of Genoa, 16126 Genoa, Italy.
³ IRCCS San Martino University Hospital, 16132 Genoa, Italy.
⁴ Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy.
⁵ Dermatology, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy.
⁶ Department of Biomedical and Dental Sciences and Morpho Functional Imaging, Section of Dermatology, University of Messina, 98122 Messina, Italy.
⁷ Dermatology Unit, IRCCS Humanitas Research Hospital, 10134 Rozzano, Italy.
⁸ Dermatology Unit, Ospedale degli Infermi, 13875 Biella, Italy.
⁹ Section of Dermatology and Venereology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari "Aldo Moro", 70124 Bari, Italy.
¹⁰ U.O.S.D. Dermatologica-Centro Per La Cura Della Psoriasi, Ospedale A. Perrino, 72100 Brindisi, Italy.
¹¹ Dermatology Unit, Ospedale S A Antonio Abate, ASP Trapani, 91016 Erice, Italy.
¹² Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico Milano, ASST Crema, 20157 Milan, Italy.
¹³ Outpatient Clinic, Section of Dermatology, ASL AL, 15100 Alessandria, Italy.
¹⁴ Division of Dermatology, Psoriasis Outpatient Service, APSS, 38122 Trento, Italy.
¹⁵ Department of Internal Medicine-Dermatology, Villa Scassi Hospital, ASL3, 16151 Genoa, Italy.
¹⁶ Unità Operativa Dipartimentale di Dermatologia e Venereologia, IRCCS San Gerardo, 20156 Milan, Italy.
¹⁷ Dermatology Unit, Agostino Gemelli University Polyclinic Foundation, IRCCS, 00168 Rome, Italy.
¹⁸ Section of Dermatology, Department of Translational Medicine and Surgery, Catholic University of the Sacred Heart, 00168 Rome, Italy.
¹⁹ Dermatology Outpatient, ASL Taranto, 74100 Taranto, Italy.
²⁰ Dermatology Unit, Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy.
²¹ Umberto I, City Hospital of Enna, 94100 Enna, Italy.
²² Section of Dermatology, Department of Medicine, ASST di Mantova, 46100 Mantova, Italy.
²³ U.O.S.D. Dermatologia, A.O. 'S.Elia'-Caltanissetta, 93100 Caltanissetta, Italy.
²⁴ Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Science, University of La Sapienza, 00161 Rome, Italy.
²⁵ Dermatology Unit, "Andrea Tortora" Hospital, ASL Salerno, 84098 Pagani, Italy.
²⁶ Unit of Dermatology, Civil Hospital of Imperia, 18039 Imperia, Italy.
²⁷ Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
²⁸ Division of Dermatology, Mons. Dimiccoli Hospital, 76121 Barletta, Italy.
²⁹ Dermatologic Clinic, AOU Maggiore della Carità Hospital, 28100 Novara, Italy.
³⁰ Section of Dermatology, Koelliker Hospital, 10126 Turin, Italy.
³¹ UO Dermatologia IRCCS Ospedale Galeazzi & Università degli Studi di Milano, 20157 Milan, Italy.
³² Department of Dermatology, Dermatology Unit Azienda Ospedaliera San Donato Milanese, 20097 Milan, Italy.
³³ Dermatology Unit, ASST Lariana, 22020 Como, Italy.
³⁴ Department of Dermatology, Istituto Dermopatico dell'Immacolata IRCCS Roma, 00167 Rome, Italy.
³⁵ Unit of Dermatology, San Bartolomeo Hospital, 19042 La Spezia, Italy.
³⁶ U.O.S.D. Dermatologia, ARNAS Garibaldi, 95123 Catania, Italy.
³⁷ UOC Dermatologia, University of Catania, PO "G. Rodolico", AOU Policlinico "G. Rodolico-San Marco", 95123 Catania, Italy.
³⁸ Fondazione Policlinico Universitario Campus Bio Medico, 00128 Rome, Italy.
³⁹ Dermatology Unit, Azienda Ospedaliera di Cosenza, 87100 Cosenza, Italy.
⁴⁰ Department of Medical Sciences, Section of Dermatology, University of Turin, 10126 Turin, Italy.
⁴¹ Department of Dermatology and Dermosurgery, AOSG San Giuseppe Moscati, 83100 Avellino, Italy.
⁴² Dermatology Unit, Manzoni Hospital, ASST-Lecco, 23900 Lecco, Italy.
⁴³ Unit of Dermatology, IRCCS Ospedale San Raffaele, 20132 Milan, Italy.

PMID: 40004618
PMCID: PMC11856090
DOI: 10.3390/jcm14041087

Effectiveness of Brodalumab for the Treatment of Moderate-to-Severe Psoriasis: A Retrospective, Real-World Multicenter Study with a Focus on Obese and Multi-Failure Patients-IL PSO (Italian Landscape Psoriasis)

Diego Orsini et al. J Clin Med. 2025.

. 2025 Feb 8;14(4):1087.

doi: 10.3390/jcm14041087.

Authors

Affiliations

¹ San Gallicano Dermatological Institute (IRCCS), 00144 Rome, Italy.
² Section of Dermatology, Department of Health Sciences (DiSSal), University of Genoa, 16126 Genoa, Italy.
³ IRCCS San Martino University Hospital, 16132 Genoa, Italy.
⁴ Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy.
⁵ Dermatology, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy.
⁶ Department of Biomedical and Dental Sciences and Morpho Functional Imaging, Section of Dermatology, University of Messina, 98122 Messina, Italy.
⁷ Dermatology Unit, IRCCS Humanitas Research Hospital, 10134 Rozzano, Italy.
⁸ Dermatology Unit, Ospedale degli Infermi, 13875 Biella, Italy.
⁹ Section of Dermatology and Venereology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari "Aldo Moro", 70124 Bari, Italy.
¹⁰ U.O.S.D. Dermatologica-Centro Per La Cura Della Psoriasi, Ospedale A. Perrino, 72100 Brindisi, Italy.
¹¹ Dermatology Unit, Ospedale S A Antonio Abate, ASP Trapani, 91016 Erice, Italy.
¹² Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico Milano, ASST Crema, 20157 Milan, Italy.
¹³ Outpatient Clinic, Section of Dermatology, ASL AL, 15100 Alessandria, Italy.
¹⁴ Division of Dermatology, Psoriasis Outpatient Service, APSS, 38122 Trento, Italy.
¹⁵ Department of Internal Medicine-Dermatology, Villa Scassi Hospital, ASL3, 16151 Genoa, Italy.
¹⁶ Unità Operativa Dipartimentale di Dermatologia e Venereologia, IRCCS San Gerardo, 20156 Milan, Italy.
¹⁷ Dermatology Unit, Agostino Gemelli University Polyclinic Foundation, IRCCS, 00168 Rome, Italy.
¹⁸ Section of Dermatology, Department of Translational Medicine and Surgery, Catholic University of the Sacred Heart, 00168 Rome, Italy.
¹⁹ Dermatology Outpatient, ASL Taranto, 74100 Taranto, Italy.
²⁰ Dermatology Unit, Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy.
²¹ Umberto I, City Hospital of Enna, 94100 Enna, Italy.
²² Section of Dermatology, Department of Medicine, ASST di Mantova, 46100 Mantova, Italy.
²³ U.O.S.D. Dermatologia, A.O. 'S.Elia'-Caltanissetta, 93100 Caltanissetta, Italy.
²⁴ Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Science, University of La Sapienza, 00161 Rome, Italy.
²⁵ Dermatology Unit, "Andrea Tortora" Hospital, ASL Salerno, 84098 Pagani, Italy.
²⁶ Unit of Dermatology, Civil Hospital of Imperia, 18039 Imperia, Italy.
²⁷ Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
²⁸ Division of Dermatology, Mons. Dimiccoli Hospital, 76121 Barletta, Italy.
²⁹ Dermatologic Clinic, AOU Maggiore della Carità Hospital, 28100 Novara, Italy.
³⁰ Section of Dermatology, Koelliker Hospital, 10126 Turin, Italy.
³¹ UO Dermatologia IRCCS Ospedale Galeazzi & Università degli Studi di Milano, 20157 Milan, Italy.
³² Department of Dermatology, Dermatology Unit Azienda Ospedaliera San Donato Milanese, 20097 Milan, Italy.
³³ Dermatology Unit, ASST Lariana, 22020 Como, Italy.
³⁴ Department of Dermatology, Istituto Dermopatico dell'Immacolata IRCCS Roma, 00167 Rome, Italy.
³⁵ Unit of Dermatology, San Bartolomeo Hospital, 19042 La Spezia, Italy.
³⁶ U.O.S.D. Dermatologia, ARNAS Garibaldi, 95123 Catania, Italy.
³⁷ UOC Dermatologia, University of Catania, PO "G. Rodolico", AOU Policlinico "G. Rodolico-San Marco", 95123 Catania, Italy.
³⁸ Fondazione Policlinico Universitario Campus Bio Medico, 00128 Rome, Italy.
³⁹ Dermatology Unit, Azienda Ospedaliera di Cosenza, 87100 Cosenza, Italy.
⁴⁰ Department of Medical Sciences, Section of Dermatology, University of Turin, 10126 Turin, Italy.
⁴¹ Department of Dermatology and Dermosurgery, AOSG San Giuseppe Moscati, 83100 Avellino, Italy.
⁴² Dermatology Unit, Manzoni Hospital, ASST-Lecco, 23900 Lecco, Italy.
⁴³ Unit of Dermatology, IRCCS Ospedale San Raffaele, 20132 Milan, Italy.

PMID: 40004618
PMCID: PMC11856090
DOI: 10.3390/jcm14041087

Abstract

Background/Objectives: Brodalumab is a monoclonal antibody against the anti-IL-17 receptor A, approved for patients with moderate-to-severe psoriasis. This retrospective study investigated patients in clinical practice to assess the impact of body weight and previous treatments with biologics on the effectiveness of brodalumab. Methods: Patients were treated according to clinical practice, and assessed at baseline, 16, 36 and 52 weeks by means of the Psoriasis Area Severity Index (PASI) and DLQI score. Overall, 299 patients were included (147 naïve to biologics). Results: Mean PASI was significantly reduced compared with the baseline in the overall population by week 4 and continued to decrease at each study time point (15.9 ± 7.9 at baseline, 5.4 ± 5.3 at week 4, 1.9 ± 3.6 at week 6, 1.0 ± 2.1 at week 36, and 0.8 ± 2.1 at week 52; p < 0.001 at each control). PASI improved significantly both in bio-naïve and bio-experienced patients (p < 0.001). The proportions of patients achieving PASI 75, PASI 90, and PASI 100 were comparable between the bio-naïve and bio-experienced groups at all time points. The percentages of patients who achieved PASI 75 were similar in obese and non-obese subjects at all determinations except the visit performed after 36 weeks of treatment (94.3% non-obese vs. 83.1% obese, p = 0.005). PASI 90 was achieved more frequently among non-obese patients than obese patients after 36 weeks (80.7% vs. 64.4%, p = 0.008) and 52 weeks of treatment (84.1% vs. 71.7%, 0.027). The probability of achieving PASI 75 and PASI 100 was independent of nutritional status at any time during the study. Conclusions: In conclusion, our results confirm that brodalumab has both rapid and sustained effectiveness in patients with moderate-to-severe psoriasis; our results could be extended to patients with multiple risk factors impairing treatment response, such as multiple biological failure and obesity.

Keywords: brodalumab; failure; interleukin-17 inhibitors; obesity; psoriasis.

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Conflict of interest statement

D. Orsini has been a speaker and/or consultant for Abbvie, LeoPharma, UCB, Bristol-Meyer-Squibb, and Boehringer-Ingelheim. R. Balestri has received support for attending meetings and/or travel from AbbVie, Amgen, Leo Pharma, Lilly, Novartis, and Sanofi. M. Burlando acted as a speaker or consultant for Abbvie, Eli Lilly, Janssen, Leo-Pharma, UCB, Novartis, Bristol-Meyer-Squibb, and Boehringer-Ingelheim. G. Caldarola has received honoraria as a speaker and consultant for Abbvie, Almirall, Biogen, Eli Lilly, LEO Pharma, Novartis, Janssen, Sanofi, Pfizer, and UCB Pharma outside the submitted work. A. Campanati has served as a speaker, consultant, or advisory board member for Abbvie, Almirall, Amgen, Eli-Lilly, Leo Pharma, Janssen-Cilag, Novartis, Pfizer, Sanofi-Aventis, Boehringer Ingelheim, and UCB Pharma. E. Campione has served as an advisory board member and received fees for lectures and/or research grants from Almirall, Amgen, Abbvie, Bristol Myers Squibb, Incyte, Leo Pharma, and UCB. A. Carugno has been a speaker and/or consultant for Almirall, Amgen, Abbvie, Boehringer-Ingelheim, Eli Lilly, Leo Pharma, Janssen-Cilag, Novartis, and UCB Pharma. A. Costanzo has been a consultant and/or speaker for AbbVie, Almirall, Amgen, Janssen, Leo Pharma, Eli Lilly, Galderma, Boehringer, Novartis, Pfizer, Sandoz, and UCB. E. Cozzani acted as a speaker or consultant for Abbvie, Almirall, Eli Lilly, Leo-Pharma, and Novartis. G. Dal Bello has been a consultant for Abbvie, Eli Lilly, Janssen, Sanofi, UCB, and Novartis. A. Dattola has served as a speaker, consultant, or advisory board member for Abbvie, Almirall, Amgen, Eli Lilly, Leo Pharma, Janssen, Novartis, Boehringer Ingelheim, and UCB Pharma outside the submitted work. M. Esposito has served as a speaker/consultant for Abbvie, Amgen, Almirall, Eli Lilly, Janssen, Leopharma, Novartis, Pfizer, Sanofi, and UCB. M.C. Fargnoli has served on advisory boards and received honoraria for lectures and/or research grants from AMGEN, Almirall, Abbvie, Boehringer-Ingelheim, BMS, Galderma, Kyowa Kyrin, Incyte, LEO Pharma, Pierre Fabre, UCB, Lilly, Pfizer, Janssen, MSD, Novartis, Sanofi, Regeneron, and Sun Pharma. C. Guarneri has received consultation fees and/or grants for research projects, advisory panels and educational lectures from Wyeth-Pfizer, Abbott Immunology-Abbvie, Janssen-Cilag, Novartis, LEO-Pharma, LEO-Pharma Denmark, Ely-Lilly, Celgene, Merck-Serono, UCB Pharma, Sanofi-Aventis, Amgen, and Almirall. P. Malagoli has been a speaker for AbbVie, Lilly, Novartis, Janssen-Cilag, Celgene, Leopharma, and Almirall. A. Narcisi has served on advisory boards and received honoraria for lectures and research grants from Almirall, AbbVie, BMS, Leo Pharma, Celgene, Eli Lilly, Janssen, Novartis, Sanofi-Genzyme, Amgen, and Boehringer Ingelheim. All conflicts of interest did not concern the present manuscript.

Figures

**Figure 1**
Mean PASI of obese and non-obese patients from baseline to 1 year from the treatment, as shown in Table 3 (Mean ± SEM).

See this image and copyright information in PMC

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Effectiveness of Brodalumab for the Treatment of Moderate-to-Severe Psoriasis: A Retrospective, Real-World Multicenter Study with a Focus on Obese and Multi-Failure Patients-IL PSO (Italian Landscape Psoriasis)

Affiliations

Effectiveness of Brodalumab for the Treatment of Moderate-to-Severe Psoriasis: A Retrospective, Real-World Multicenter Study with a Focus on Obese and Multi-Failure Patients-IL PSO (Italian Landscape Psoriasis)

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

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