Brodalumab Efficacy in Psoriasis Patients with Inadequate Response to IL-23 or IL-12/23 Inhibitors: Multicenter Italian Retrospective Analysis - IL PSO (Italian Landscape Psoriasis)

Diego Orsini^{1

2}, Maria Concetta Fargnoli², Martina Burlando^{3

4}, Anna Campanati⁵, Elena Campione⁶, Claudio Guarneri⁷, Alessandra Narcisi⁸, Paolo Pella⁹, Paolo Romita¹⁰, Massimo Travaglini¹¹, Leonardo Zichichi¹², Luisa Maria Halina Arancio¹³, Chiara Assorgi¹⁴, Ginevra Baggini¹⁵, Riccardo Balestri¹⁶, Luca Bianchi⁶, Alexandra Maria Giovanna Brunasso¹⁷, Anna Elisabetta Cagni¹⁸, Giacomo Caldarola^{19

20}, Gianluca Calianno¹⁰, Antonio Carpentieri¹¹, Martino Carriero²¹, Andrea Carugno²², Franco Cona²³, Antonio Costanzo⁸, Emanuele Cozzani^{3

4}, Giacomo Dal Bello²⁴, Paolo Dapavo²⁵, Annunziata Dattola¹⁴, Antonio Di Tano⁷, Federico Diotallevi⁵, Marianna Donnarumma²⁶, Elena De Col²⁷, Maria Esposito²⁸, Carmen Silvia Fiorella²⁹, Marco Galluzzo⁶, Francesca Graziola³⁰, Giovanni Carlo Lazzaro Danzuso³¹, Matteo Licciardello³², Agostina Legori³³, Viviana Lora², Piergiorgio Malagoli³⁴, Matteo Megna³⁵, Federica Mola³⁶, Gaia Moretta³⁷, Andrea Muracchioli³⁸, Attilia Musumeci³⁹, Maria Letizia Musumeci⁴⁰, Gianluca Pagnanelli³⁷, Vincenzo Panasiti⁴¹, Eugenio Provenzano⁴², Simone Ribero²⁵, Daniele Rizzo¹², Marco Rubatto⁴³, Oriele Sarno⁴⁴, Davide Strippoli⁴⁵, Fabrizio Vaira⁴⁶, Dario Graceffa²

Affiliations

¹ Departmental Faculty of Medicine, UniCamillus - "Saint Camillus International University of Health and Medical Sciences", Rome, Italy.
² San Gallicano Dermatological Institute (IRCCS), Rome, Italy.
³ Section of Dermatology, Department of Health Sciences (DiSSal), University of Genoa, Genoa, Italy.
⁴ IRCCS San Martino University Hospital, Genoa, Italy.
⁵ Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy.
⁶ Dermatology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
⁷ Department of Biomedical and Dental Sciences and Morpho Functional Imaging, Section of Dermatology, University of Messina, Italy.
⁸ Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy.
⁹ Dermatology Unit, Ospedale degli Infermi, Biella, Italy.
¹⁰ Section of Dermatology and Venereology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari "Aldo Moro", Bari, Italy.
¹¹ U.O.S.D. Dermatologica - Centro per la cura della psoriasi, Ospedale A. Perrino, Brindisi, Italy.
¹² Dermatology Unit, Ospedale S A Antonio Abate, ASP Trapani, 91016, Erice, Italy.
¹³ Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico Milano; ASST Crema, Italy.
¹⁴ Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Science, University of La Sapienza, Rome, Italy.
¹⁵ Outpatient Clinic, Section of Dermatology, ASL AL, Alessandria, Italy.
¹⁶ Division of Dermatology, Psoriasis Outpatient Service, APSS, Trento, Italy.
¹⁷ Department of Internal Medicine-Dermatology, Villa Scassi Hospital, ASL3, Genoa, Italy.
¹⁸ Unità Operativa Dipartimentale di Dermatologia e Venereologia, IRCCS San Gerardo, Milan, Italy.
¹⁹ Dermatology Unit, Agostino Gemelli University Polyclinic Foundation, IRCCS, Rome, Italy.
²⁰ Section of Dermatology, Department of Translational Medicine and Surgery, Catholic University of the Sacred Heart, Rome, Italy.
²¹ Dermatology Outpatient, ASL Taranto, Italy.
²² Dermatology Unit, Department of Medicine and Surgery, University of Insubria, Varese, Italy.
²³ Umberto I, City Hospital of Enna, Enna, Italy.
²⁴ Section of Dermatology, Department of Medicine, ASST di Mantova, Mantova, Italy.
²⁵ Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy.
²⁶ Dermatology Unit, "Andrea Tortora" Hospital, ASL Salerno, Pagani, Italy.
²⁷ Unit of Dermatology, Civil Hospital of Imperia, Imperia, Italy.
²⁸ Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
²⁹ Division of Dermatology, "Mons. Dimiccoli" Hospital, Barletta, Italy.
³⁰ Dermatologic Clinic, AOU Maggiore della Carità Hospital, Novara, Italy.
³¹ U.O.S.D Dermatologia, A.O. 'S.Elia' - Caltanissetta, Caltanissetta, Italy.
³² Section of Dermatology, Koelliker Hospital, Turin, Italy.
³³ UO Dermatologia IRCCS Ospedale Galeazzi & Università degli Studi di Milano, Milan, Italy.
³⁴ Department of Dermatology, Dermatology Unit Azienda Ospedaliera San Donato Milanese, 20097 Milan, Italy.
³⁵ Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
³⁶ Dermatology Unit, ASST Lariana, Como, Italy.
³⁷ Department of Dermatology, Istituto Dermopatico dell'Immacolata IRCCS Roma, Roma, Italy.
³⁸ Unit of Dermatology, San Bartolomeo Hospital, La Spezia, Italy.
³⁹ UOSD Dermatologia, ARNAS Garibaldi, Catania, Italy.
⁴⁰ UOC Dermatologia, University of Catania, PO "G. Rodolico", AOU Policlinico "G. Rodolico-San Marco", Catania, Italy.
⁴¹ Fondazione Policlinico Universitario Campus Bio Medico, Rome, Italy.
⁴² Dermatology Unit, Azienda Ospedaliera di Cosenza, Cosenza, Italy.
⁴³ Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy.
⁴⁴ Department of Dermatology and Dermosurgery, AOSG San Giuseppe Moscati, Avellino, Italy.
⁴⁵ Dermatology Unit, Manzoni Hospital, ASST-Lecco, Lecco, Italy.
⁴⁶ Unit of Dermatology, IRCCS Ospedale San Raffaele, Milan, Italy.

PMID: 41236266
PMCID: PMC12615071
DOI: 10.5826/dpc.1504a6010

Brodalumab Efficacy in Psoriasis Patients with Inadequate Response to IL-23 or IL-12/23 Inhibitors: Multicenter Italian Retrospective Analysis - IL PSO (Italian Landscape Psoriasis)

Diego Orsini et al. Dermatol Pract Concept. 2025.

. 2025 Oct 1;15(4):e20256010.

doi: 10.5826/dpc.1504a6010.

Authors

Affiliations

¹ Departmental Faculty of Medicine, UniCamillus - "Saint Camillus International University of Health and Medical Sciences", Rome, Italy.
² San Gallicano Dermatological Institute (IRCCS), Rome, Italy.
³ Section of Dermatology, Department of Health Sciences (DiSSal), University of Genoa, Genoa, Italy.
⁴ IRCCS San Martino University Hospital, Genoa, Italy.
⁵ Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy.
⁶ Dermatology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
⁷ Department of Biomedical and Dental Sciences and Morpho Functional Imaging, Section of Dermatology, University of Messina, Italy.
⁸ Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy.
⁹ Dermatology Unit, Ospedale degli Infermi, Biella, Italy.
¹⁰ Section of Dermatology and Venereology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari "Aldo Moro", Bari, Italy.
¹¹ U.O.S.D. Dermatologica - Centro per la cura della psoriasi, Ospedale A. Perrino, Brindisi, Italy.
¹² Dermatology Unit, Ospedale S A Antonio Abate, ASP Trapani, 91016, Erice, Italy.
¹³ Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico Milano; ASST Crema, Italy.
¹⁴ Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Science, University of La Sapienza, Rome, Italy.
¹⁵ Outpatient Clinic, Section of Dermatology, ASL AL, Alessandria, Italy.
¹⁶ Division of Dermatology, Psoriasis Outpatient Service, APSS, Trento, Italy.
¹⁷ Department of Internal Medicine-Dermatology, Villa Scassi Hospital, ASL3, Genoa, Italy.
¹⁸ Unità Operativa Dipartimentale di Dermatologia e Venereologia, IRCCS San Gerardo, Milan, Italy.
¹⁹ Dermatology Unit, Agostino Gemelli University Polyclinic Foundation, IRCCS, Rome, Italy.
²⁰ Section of Dermatology, Department of Translational Medicine and Surgery, Catholic University of the Sacred Heart, Rome, Italy.
²¹ Dermatology Outpatient, ASL Taranto, Italy.
²² Dermatology Unit, Department of Medicine and Surgery, University of Insubria, Varese, Italy.
²³ Umberto I, City Hospital of Enna, Enna, Italy.
²⁴ Section of Dermatology, Department of Medicine, ASST di Mantova, Mantova, Italy.
²⁵ Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy.
²⁶ Dermatology Unit, "Andrea Tortora" Hospital, ASL Salerno, Pagani, Italy.
²⁷ Unit of Dermatology, Civil Hospital of Imperia, Imperia, Italy.
²⁸ Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
²⁹ Division of Dermatology, "Mons. Dimiccoli" Hospital, Barletta, Italy.
³⁰ Dermatologic Clinic, AOU Maggiore della Carità Hospital, Novara, Italy.
³¹ U.O.S.D Dermatologia, A.O. 'S.Elia' - Caltanissetta, Caltanissetta, Italy.
³² Section of Dermatology, Koelliker Hospital, Turin, Italy.
³³ UO Dermatologia IRCCS Ospedale Galeazzi & Università degli Studi di Milano, Milan, Italy.
³⁴ Department of Dermatology, Dermatology Unit Azienda Ospedaliera San Donato Milanese, 20097 Milan, Italy.
³⁵ Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
³⁶ Dermatology Unit, ASST Lariana, Como, Italy.
³⁷ Department of Dermatology, Istituto Dermopatico dell'Immacolata IRCCS Roma, Roma, Italy.
³⁸ Unit of Dermatology, San Bartolomeo Hospital, La Spezia, Italy.
³⁹ UOSD Dermatologia, ARNAS Garibaldi, Catania, Italy.
⁴⁰ UOC Dermatologia, University of Catania, PO "G. Rodolico", AOU Policlinico "G. Rodolico-San Marco", Catania, Italy.
⁴¹ Fondazione Policlinico Universitario Campus Bio Medico, Rome, Italy.
⁴² Dermatology Unit, Azienda Ospedaliera di Cosenza, Cosenza, Italy.
⁴³ Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy.
⁴⁴ Department of Dermatology and Dermosurgery, AOSG San Giuseppe Moscati, Avellino, Italy.
⁴⁵ Dermatology Unit, Manzoni Hospital, ASST-Lecco, Lecco, Italy.
⁴⁶ Unit of Dermatology, IRCCS Ospedale San Raffaele, Milan, Italy.

PMID: 41236266
PMCID: PMC12615071
DOI: 10.5826/dpc.1504a6010

Abstract

Introduction: The use of brodalumab in patients with psoriasis who have failed other biologic drugs is an underexplored topic.

Objectives: To evaluate the safety and the efficacy of brodalumab in a subgroup of psoriasis patients who already failed anti-IL23 or anti-IL12/23 treatment.

Methods: Using the Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI), we retrospectively evaluated a cohort of 23 patients with psoriasis who underwent a change in therapy with brodalumab exclusively following primary or secondary therapeutic failure of anti-IL-23 or anti-12/23 drugs.

Results: The mean PASI decreased significantly following the introduction of brodalumab after four weeks of treatment, continuing to decrease at 16 and 36 weeks, reaching the nadir at 52 weeks (baseline PASI baseline: 14.6 ± 9.2 vs. 52 weeks PASI: 1.1 ± 1.8; P<0.001). Sixty-three point six percent of patients reached PASI 100 just after 16 weeks. The same trend of improvement was also observed for the DLQI. The adverse effects observed in our study population were generally mild.

Conclusions: Our results are in line with the current literature and suggest that patients who have failed therapy with IL-23 or IL-12/23 inhibitors may benefit from switching to brodalumab, which could be considered a good choice for patients who need a rapid resolution of the inflammatory skin condition.

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Conflict of interest statement

Competing Interests: 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 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 advisory board member, received fees for lectures, and/or research grants by 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 speaker/consultant for Abbvie, Amgen, Almirall, Eli Lilly, Janssen, Leopharma, Novartis, Pfizer, Sanofi, and UCB. M.C. Fargnoli has served on advisory boards, 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 giving educational lectures from Wyeth-Pfizer, Abbott Immunology-Abbvie, Janssen-Cilag, Novartis, LEO-Pharma, LEOPharma 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, received honoraria for lectures and research grants from Almirall, AbbVie, BMS, Leo Pharma, Celgene, Eli Lilly, Janssen, Novartis, Sanofi-Genzyme, Amgen, and Boehringer Ingelheim.

Figures

**Figure 2**
Relative PASI over One Year.

See this image and copyright information in PMC

References

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Brodalumab Efficacy in Psoriasis Patients with Inadequate Response to IL-23 or IL-12/23 Inhibitors: Multicenter Italian Retrospective Analysis - IL PSO (Italian Landscape Psoriasis)

Affiliations

Brodalumab Efficacy in Psoriasis Patients with Inadequate Response to IL-23 or IL-12/23 Inhibitors: Multicenter Italian Retrospective Analysis - IL PSO (Italian Landscape Psoriasis)

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

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