Novel psoriasis drugs show high clearance rates

International report - Two experimental psoriasis drugs that target the interleukin(IL)-17 signaling pathway led to significant improvements in skin lesions for a majority patients over 12 weeks, separate phase 2 studies show. The majority of patients receiving one of the drugs at a higher dose showed total clearance.

In one study, a research team led by Kim Papp, M.D., Ph.D., of Probity Medical Research in Waterloo, Ontario, randomly assigned 198 patients with moderate-to-severe psoriasis to receive various dosages of brodalumab (Amgen) or placebo over 12 weeks. Brodalumab is a human monoclonal antibody that selectively binds to and blocks signaling via the IL-17 receptor.

PRNewswire reports that at week 12, the mean percentage improvements in the psoriasis area and severity index (PASI) scores were 45 percent among patients receiving 70 mg of brodalumab; 85.9 percent among those receiving 140 mg; 86.3 percent among those receiving 210 mg; and 76 percent among those receiving 280 mg. The mean percentage improvement in the placebo patients was 16 percent. Sixty-two percent of patients who received 210 mg of brodalumab every other week achieved total clearance.

In the second study, involving 142 patients, researchers led by Craig Leonardi, M.D., of Saint Louis University, St. Louis, saw a reduction of 75 percent in PASI scores in 77 to 83 percent of patients who received higher doses of the humanized IgG4 monoclonal antibody ixekizumab (Eli Lilly), compared with 8 percent of the placebo group. Medpage Today reports that response to treatment was apparent by the end of the second week.

Ixekizumab targets interleukin-17 directly, while brodalumab targets a receptor.

Both studies were published in the March 29 issue of the New England Journal of Medicine. In an editorial accompanying the studies, Ari Waisman, Ph.D., of the Johannes-Gutenberg University of Mainz in Germany, noted that biologic therapies have greatly improved the treatment of psoriasis, but can have drawbacks such as risks for severe infections, and that more targeted therapies could provide further benefit.

“Treatment with antibodies targeting interleukin-17 or its receptor should be more specific and may be expected to result in fewer side effects, and therefore holds promise for patients with psoriasis,” Dr. Waisman wrote in the editorial.

Amgen funded the brodalumab study; Eli Lilly funded the ixekizumab study.

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