Patient-Level Cumulative Clinical Benefit of Brodalumab Over 52 Weeks: A Multicentre Real-World Study-IL PSO (Italian Landscape Psoriasis)

INTRODUCTION: Conventional Psoriasis Area and Severity Index (PASI) response rates provide a cross-sectional assessment of treatment effectiveness but do not capture the speed, magnitude, and persistence of clinical improvement. This study evaluated the patient-level cumulative clinical benefit of brodalumab over 52 weeks in routine clinical practice. METHODS: This multicentre, retrospective, observational study included adults with moderate-to-severe plaque psoriasis treated with brodalumab within the Italian Landscape Psoriasis database. The primary analysis included patients with PASI assessments at baseline and Weeks 16, 32, and 52. Individual percentage PASI improvement trajectories were integrated using the trapezoidal area under the curve and expressed as normalized cumulative clinical benefit and clearance-equivalent days. Baseline factors associated with cumulative benefit were assessed using multivariable median quantile regression. RESULTS: Among 858 patients eligible for the 52-week analysis, 764 had complete longitudinal PASI data, and 645 were included in the multivariable analysis. Median PASI decreased from 14.7 at baseline to 0.0 at Weeks 16, 32, and 52. At Week 52, 93.1%, 86.1%, and 70.4% of patients achieved PASI 75, PASI 90, and PASI 100, respectively. Median normalized cumulative clinical benefit was 97.4% (interquartile range, 90.0-100.0), corresponding to 300.0 clearance-equivalent days (277.2-308.0). Palmoplantar involvement was independently associated with lower cumulative benefit (adjusted median difference, - 3.21 percentage points; 95% confidence interval, - 6.29 to - 0.87), whereas scalp or facial involvement was associated with modestly higher benefit (+ 1.39; 0.38-3.27). Longer psoriasis duration was associated with a small increase in cumulative benefit. CONCLUSION: Brodalumab provided rapid, deep, and sustained disease control over 52 weeks. Patient-level cumulative outcomes may complement conventional PASI response rates by capturing the overall longitudinal treatment benefit.

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Journal
Dermatology and Therapy
Published
2026-09-17
DOI
https://doi.org/10.1007/s13555-026-01925-5
Primary Topic
Psoriasis: Treatment and Pathogenesis
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article
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article

Patient-Level Cumulative Clinical Benefit of Brodalumab Over 52 Weeks: A Multicentre Real-World Study-IL PSO (Italian Landscape Psoriasis)

Diego Orsini, Marco Campoli, Martina Maurelli, Simone Ribero et al.
Dermatology and Therapy
Psoriasis: Treatment and Pathogenesis
article

Patient-Level Cumulative Clinical Benefit of Brodalumab Over 52 Weeks: A Multicentre Real-World Study-IL PSO (Italian Landscape Psoriasis)

Diego Orsini, Marco Campoli, Martina Maurelli, Simone Ribero, Caterina Longo, Maria Esposito, Annunziata Dattola, Eugenia Veronica Di Brizzi, Matteo Megna, Emanuele Cozzani, Claudia Lasagni, Massimo Travaglini, Anna Campanati, Salvatore Scibetta, Chiara Assorgi, Lidia Sacchelli, Luca Potestio, Martina Burlando, Nello Tommasino, Stefano Caccavale, Alessandra Michelucci, Alessandra Narcisi, Francesca Maria Gaiani, Rosa Giuseppa Angileri, Dario Valguarnera, Luca Cangialosi, Francesca Lussana, Simone Mozzato, Nicola Zerbinati, Luigi Gargiulo, Claudio Guarneri, Federico Bardazzi, Anna Balato, Giampiero Girolomoni, Francesco Messina, Luca Mastorino, Andrea Carugno, Lorenzo Mercadante, Francesco Loconsole, Salvatore Corrao, Piergiorgio Malagoli, Angelo Valerio Marzano, Emanuele Trovato, Matteo Bianco, Valentina Dini, Sara Marchetti, Carlo Giovanni Carrera
article en

Abstract

INTRODUCTION: Conventional Psoriasis Area and Severity Index (PASI) response rates provide a cross-sectional assessment of treatment effectiveness but do not capture the speed, magnitude, and persistence of clinical improvement. This study evaluated the patient-level cumulative clinical benefit of brodalumab over 52 weeks in routine clinical practice. METHODS: This multicentre, retrospective, observational study included adults with moderate-to-severe plaque psoriasis treated with brodalumab within the Italian Landscape Psoriasis database. The primary analysis included patients with PASI assessments at baseline and Weeks 16, 32, and 52. Individual percentage PASI improvement trajectories were integrated using the trapezoidal area under the curve and expressed as normalized cumulative clinical benefit and clearance-equivalent days. Baseline factors associated with cumulative benefit were assessed using multivariable median quantile regression. RESULTS: Among 858 patients eligible for the 52-week analysis, 764 had complete longitudinal PASI data, and 645 were included in the multivariable analysis. Median PASI decreased from 14.7 at baseline to 0.0 at Weeks 16, 32, and 52. At Week 52, 93.1%, 86.1%, and 70.4% of patients achieved PASI 75, PASI 90, and PASI 100, respectively. Median normalized cumulative clinical benefit was 97.4% (interquartile range, 90.0-100.0), corresponding to 300.0 clearance-equivalent days (277.2-308.0). Palmoplantar involvement was independently associated with lower cumulative benefit (adjusted median difference, - 3.21 percentage points; 95% confidence interval, - 6.29 to - 0.87), whereas scalp or facial involvement was associated with modestly higher benefit (+ 1.39; 0.38-3.27). Longer psoriasis duration was associated with a small increase in cumulative benefit. CONCLUSION: Brodalumab provided rapid, deep, and sustained disease control over 52 weeks. Patient-level cumulative outcomes may complement conventional PASI response rates by capturing the overall longitudinal treatment benefit.

Dermatology and Therapy
University of Siena (IT), University of Messina (IT), University of Insubria (IT), University of Verona (IT), University of Modena and Reggio Emilia (IT), Marche Polytechnic University (IT), Humanitas University (IT), University of Milan (IT), University of Campania "Luigi Vanvitelli" (IT), University of L'Aquila (IT), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT), Ospedale Santa Chiara (IT), Saint Camillus International University of Health and Medical Sciences (IT), IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola (IT), IRCCS Policlinico San Donato (IT), Ospedale A. Perrino (IT), Institute for Biomedical Research and Innovation (IT), Center for Translational Neurophysiology of Speech and Communication (IT), Azienda di Rilievo Nazionale ed Alta Specializzazione (IT), Ospedale Policlinico San Martino (IT), National Research Council (IT), IRCCS Humanitas Research Hospital (IT), University of Turin (IT), University of Bari Aldo Moro (IT), University of Naples Federico II (IT), Sapienza University of Rome (IT), National Institute for Astrophysics (IT), University of Palermo (IT), University of Bologna (IT)
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