Treatment with brodalumab improves skin pain and itching in psoriasis patients

The study showed that skin pain disappeared with improvement in psoriatic lesions in many patients. Although itching did not follow the same trend, its level decreased with the improvement in psoriatic lesions, suggesting that getting clear or almost clear skin does not always lead to itching elimination in psoriasis.

"The initial goal for psoriasis treatment could be set as a PASI (Psoriasis Area and Severity Index) score of ≤2 and the long-term treatment goal following achievement of the initial goal as an Itch (Numeric Rating Scale) NRS score of 0, from the point of view of health-related quality of life (HRQoL) and treatment satisfaction," the authors wrote in their study.

Psoriasis is a chronic inflammatory disease, about 0.84% (or 64.6 million people) of the world's population are affected by it as of 2017. Over the last three decades, there has been an increase in its incidence. Skin pain and itching are bothersome psoriasis symptoms, but there is not much evidence regarding the effectiveness of treatment on these symptoms in daily clinical settings.

Against the above background, Masaru Honma, Department of Dermatology, Asahikawa Medical University, Asahikawa, Japan, and colleagues assessed the changes in skin pain and itching levels after treatment with brodalumab in Japanese psoriasis patients using patient-reported outcomes (PROs).

They enrolled seventy-three psoriasis patients ((men, 82.2%; median age, 54.0 years) who have an inadequate response to existing treatments in the open-label, single-arm, multicenter, prospective ProLOGUE study. They received brodalumab 210 mg subcutaneously in daily clinical practice. PRO and PASI assessments were done at baseline and weeks 12 and 47.

The authors reported the following findings:

• The Itch Numeric Rating Scale (NRS at weeks 12 and 48) and Skin Pain NRS (week 12, week 48) scores remarkably decreased from baseline.
• The Itch NRS score was significantly higher in patients with a Dermatology Life Quality Index (DLQI) score of ≥2 (vs. 0/1 at weeks 12 and 48) and patients with a Treatment Satisfaction Questionnaire for Medication-9 (TSQM-9) global satisfaction domain score of ≤70% (vs. >70%; week 12; week 48).
• The Itch NRS score cutoff value for achieving a PASI score of ≤2, DLQI score of 0/1, and TSQM-9 global satisfaction domain score of >70% was one at week 12 and 0 at week 48.

To conclude, brodalumab treatment was linked with improved skin pain and itching in Japanese patients with psoriasis.

"An Itch NRS score of 0 can be a long-term treatment goal for psoriasis," the authors suggested.

Reference:

Honma M, Kanai Y, Murotani K, Ito K, Ohata C, Yamazaki F, Saeki H, Seishima M, Mizutani Y, Kitabayashi H, Imafuku S. Effectiveness of brodalumab in improving itching and skin pain in Japanese patients with psoriasis: The ProLOGUE study. J Dermatol. 2022 Dec 20. doi: 10.1111/1346-8138.16682. Epub ahead of print. PMID: 36540010.