Brodalumab is recommended by NICE as an option for treating plaque psoriasis if:
- the disease is severe, as defined by a total Psoriasis Area and Severity Index (PASI) of 10 or more and a Dermatology Life Quality Index (DLQI) of more than 10, and
- the disease has not responded to other systemic therapies, including ciclosporin, methotrexate and PUVA (psoralen and long-wave ultraviolet A radiation), or these options are contraindicated or not tolerated.
Approval of brodalumab for NHS use was granted on the condition that the biologic continue to be provided with the discount agreed in the patient access scheme.
NICE states that brodalumab treatment should be stopped at 12 weeks if psoriasis has not responded adequately (defined as a 75% reduction in the PASI score, or a 50% reduction in the PASI score and a 5-point reduction in DLQI from baseline).
'Once this recommendation is implemented, brodalumab, with its differentiated mode of action, will represent a valuable treatment option,' said Professor Richard Warren, Consultant Dermatologist at Salford Royal NHS Foundation Trust and the University of Manchester.
Mode of action
Brodalumab differs from other biologic therapies for psoriasis as it blocks the activity of pro-inflammatory cytokines involved in plaque formation by specifically targeting the interleukin-17 receptor on skin cells, as opposed to free-floating inflammatory mediators.