Efficacy of Brodalumab and Guselkumab in Patients with Moderate-to-Severe Plaque Psoriasis Who are Inadequate Responders to Ustekinumab: A Matching Adjusted Indirect Comparison

Philip Hampton,1 Emma Borg,2 Jes Birger Hansen,2 Matthias Augustin3 1Department of Dermatology, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK; 2LEO Pharma A/S, Ballerup, Denmark; 3Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Cen...

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Autores principales: Hampton P, Borg E, Hansen JB, Augustin M
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Publicado: Dove Medical Press 2021
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spelling oai:doaj.org-article:305c7a0ed75d4f8ca264b55011c7cced2021-12-02T18:10:29ZEfficacy of Brodalumab and Guselkumab in Patients with Moderate-to-Severe Plaque Psoriasis Who are Inadequate Responders to Ustekinumab: A Matching Adjusted Indirect Comparison2230-326Xhttps://doaj.org/article/305c7a0ed75d4f8ca264b55011c7cced2021-11-01T00:00:00Zhttps://www.dovepress.com/efficacy-of-brodalumab-and-guselkumab-in-patients-with-moderate-to-sev-peer-reviewed-fulltext-article-PTThttps://doaj.org/toc/2230-326XPhilip Hampton,1 Emma Borg,2 Jes Birger Hansen,2 Matthias Augustin3 1Department of Dermatology, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK; 2LEO Pharma A/S, Ballerup, Denmark; 3Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, GermanyCorrespondence: Philip HamptonDepartment of Dermatology, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, NE7 7DN, UKEmail philip.hampton@nhs.netPurpose: Both brodalumab and guselkumab improve skin clearance in patients with moderate-to-severe plaque psoriasis after inadequate response to ustekinumab. In the absence of a direct head-to-head comparison, the relative efficacy of brodalumab and guselkumab in non-responders to ustekinumab were compared using a matching-adjusted indirect comparison (MAIC).Patients and Methods: Individual patient data for brodalumab (n = 121) were pooled from the AMAGINE-2 and -3 trials and adjusted using a propensity score reweighting method, so that baseline and week 16 characteristics matched the aggregate published data of patients with an inadequate response to ustekinumab who switched to guselkumab (n = 135) in the NAVIGATE trial.Results: After inadequate response to ustekinumab, brodalumab resulted in significantly higher psoriasis area and severity index (PASI) 90 rates versus guselkumab at post-treatment switch week 12 (62.7% vs 48.1%, relative difference 14.6% [95% confidence interval [CI] 5.3– 23.9], p = 0.002 [number needed to treat [NNT] = 6.8]) and week 36 (63.7% vs 51.1%; relative difference 12.6% [95% CI 4.1– 21.0]; p = 0.004 [NNT = 7.9]) and PASI 100 rate at week 36 (40.3% vs 20.0%; relative difference 20.3% [95% CI 11.8– 28.7]; p < 0.001 [NNT = 4.9]).Conclusion: In this MAIC, brodalumab was associated with greater improvements than guselkumab in inadequate responders to ustekinumab. Switching to brodalumab in such patients may be a more effective strategy than switching to guselkumab.Keywords: brodalumab, guselkumab, psoriasisHampton PBorg EHansen JBAugustin MDove Medical PressarticlebrodalumabguselkumabpsoriasisDermatologyRL1-803ENPsoriasis: Targets and Therapy, Vol Volume 11, Pp 123-131 (2021)
institution DOAJ
collection DOAJ
language EN
topic brodalumab
guselkumab
psoriasis
Dermatology
RL1-803
spellingShingle brodalumab
guselkumab
psoriasis
Dermatology
RL1-803
Hampton P
Borg E
Hansen JB
Augustin M
Efficacy of Brodalumab and Guselkumab in Patients with Moderate-to-Severe Plaque Psoriasis Who are Inadequate Responders to Ustekinumab: A Matching Adjusted Indirect Comparison
description Philip Hampton,1 Emma Borg,2 Jes Birger Hansen,2 Matthias Augustin3 1Department of Dermatology, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK; 2LEO Pharma A/S, Ballerup, Denmark; 3Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, GermanyCorrespondence: Philip HamptonDepartment of Dermatology, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, NE7 7DN, UKEmail philip.hampton@nhs.netPurpose: Both brodalumab and guselkumab improve skin clearance in patients with moderate-to-severe plaque psoriasis after inadequate response to ustekinumab. In the absence of a direct head-to-head comparison, the relative efficacy of brodalumab and guselkumab in non-responders to ustekinumab were compared using a matching-adjusted indirect comparison (MAIC).Patients and Methods: Individual patient data for brodalumab (n = 121) were pooled from the AMAGINE-2 and -3 trials and adjusted using a propensity score reweighting method, so that baseline and week 16 characteristics matched the aggregate published data of patients with an inadequate response to ustekinumab who switched to guselkumab (n = 135) in the NAVIGATE trial.Results: After inadequate response to ustekinumab, brodalumab resulted in significantly higher psoriasis area and severity index (PASI) 90 rates versus guselkumab at post-treatment switch week 12 (62.7% vs 48.1%, relative difference 14.6% [95% confidence interval [CI] 5.3– 23.9], p = 0.002 [number needed to treat [NNT] = 6.8]) and week 36 (63.7% vs 51.1%; relative difference 12.6% [95% CI 4.1– 21.0]; p = 0.004 [NNT = 7.9]) and PASI 100 rate at week 36 (40.3% vs 20.0%; relative difference 20.3% [95% CI 11.8– 28.7]; p < 0.001 [NNT = 4.9]).Conclusion: In this MAIC, brodalumab was associated with greater improvements than guselkumab in inadequate responders to ustekinumab. Switching to brodalumab in such patients may be a more effective strategy than switching to guselkumab.Keywords: brodalumab, guselkumab, psoriasis
format article
author Hampton P
Borg E
Hansen JB
Augustin M
author_facet Hampton P
Borg E
Hansen JB
Augustin M
author_sort Hampton P
title Efficacy of Brodalumab and Guselkumab in Patients with Moderate-to-Severe Plaque Psoriasis Who are Inadequate Responders to Ustekinumab: A Matching Adjusted Indirect Comparison
title_short Efficacy of Brodalumab and Guselkumab in Patients with Moderate-to-Severe Plaque Psoriasis Who are Inadequate Responders to Ustekinumab: A Matching Adjusted Indirect Comparison
title_full Efficacy of Brodalumab and Guselkumab in Patients with Moderate-to-Severe Plaque Psoriasis Who are Inadequate Responders to Ustekinumab: A Matching Adjusted Indirect Comparison
title_fullStr Efficacy of Brodalumab and Guselkumab in Patients with Moderate-to-Severe Plaque Psoriasis Who are Inadequate Responders to Ustekinumab: A Matching Adjusted Indirect Comparison
title_full_unstemmed Efficacy of Brodalumab and Guselkumab in Patients with Moderate-to-Severe Plaque Psoriasis Who are Inadequate Responders to Ustekinumab: A Matching Adjusted Indirect Comparison
title_sort efficacy of brodalumab and guselkumab in patients with moderate-to-severe plaque psoriasis who are inadequate responders to ustekinumab: a matching adjusted indirect comparison
publisher Dove Medical Press
publishDate 2021
url https://doaj.org/article/305c7a0ed75d4f8ca264b55011c7cced
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