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vol. 59
Letter to the Editor

Brodalumab in the treatment of psoriatic arthritis – the latest reports

Katarzyna Banaszczyk

Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
Reumatologia 2021; 59, 2: 126–127
Online publish date: 2021/04/27
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JabRef, Mendeley
Papers, Reference Manager, RefWorks, Zotero
Dear Editor,
The quest to find an optimal and effective treatment for psoriatic arthritis (PsA) is expanding research to new molecules and inhibiting further pathways in the pathogenesis of inflammation in PsA. In this report, I would like to draw your attention to brodalumab, a fully human IgG2 monoclonal antibody, which binds to human interleukin 17RA. Binding of this interleukin leads to blockade of the biological activity of the pro-inflammatory cytokines IL-17A, IL-17F, the heterodi­mer IL-17A/F, IL-17C and IL-17E [1]. It is worth being aware that IL-17A, IL-17F and the IL-17A/F heterodi­mer have a multidirectional effect; they induce pro-inflammatory mediators such as IL-6, GRO and G-CSF from epithelial cells and fibroblasts, which affect the ongoing state of inflammatory tissues [2]. Brodalumab is used to treat mode­rate to severe plaque psoriasis (USA, Canada). Currently, brodalumab is also used to treat PsA but only in Japan [3].
It is worth emphasizing that brodalumab was effective in phase II clinical trials in PsA patients. Brodalumab has been used in a randomized, double-blind, and placebo-controlled trial. In this clinical trial, doses of 140 mg and 280 mg of brodalumab were administered once weekly for 12 weeks. Administration of brodalumab was associated with a significantly better clinical response compared to placebo (American College of Rheumatology 20 [ACR20] as the primary endpoint) [4]. The encouraging results of the second phase trials have prompted clinicians to conduct larger clinical trials. It is worth getting acquainted with the latest phase III study, the results of which were published at the end of October 2020.
What are the results of phase III trials of brodalu­mab in PsA? AMVISION-1 and AMVISION-2 trials At the end of October 2020, the results of phase III clinical trials on the use of brodalumab in PsA were published [5]. These were double-blind, randomized, and placebo-controlled studies. The studies involved adult patients with active PsA who had been ill for at least 6 months. These patients did not tolerate traditional treatment or the treatment was insufficient. Additional inclusion criteria were having at least three painful and three swollen joints as well as active psoriatic lesions on the skin.
Patients (both in AMVISION-1 and AMVISION-2) were divided into three groups in a 1 : 1 : 1 ratio and received subcutaneous...

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