SYNOPSIS • Brodalumab is a fully human interleukin-17 receptor A antagonist approved for the treatment of moderate-to-severe plaque psoriasis in adult patients with inadequate response or loss of response to other systemic therapies1 METHODS • In AMAGINE-2/-3 (NCT01708603 and NCT01708629), after a 12-week induction phase, patients received maintenance treatment as follows: brodalumab-treated patients were rerandomized to brodalumab 210 mg every 2 weeks (Q2W); ustekinumab-treated patients continued to receive ustekinumab; and patients receiving placebo switched to brodalumab 210 mg Q2W2 • At week 16, patients with inadequate response to ustekinumab (single static physician’s global assessment [sPGA] of ≥3 or persistent sPGA of 2 over ≥4 weeks) were eligible for rescue with brodalumab 210 mg Q2W. After week 16, patients on ustekinumab with an inadequate response remained on ustekinumab • Efficacy was assessed by psoriasis area and severity index 75%, 90%, and 100% response rates (PASI 75, 90, and 100) for patients who were rescued with 36 weeks of brodalumab 210 mg Q2W after an inadequate response to ustekinumab at week 16 (N=124) and for patients who continued on ustekinumab after an inadequate response to ustekinumab after week 16 (N=149), stratified by tumor necrosis factor α (TNFα) inhibitor treatment before entering the study (no prior TNFα inhibitor experience, prior TNFα inhibitor nonfailure, or prior TNFα inhibitor failure) RESULTS • At week 52, after 36 weeks of retreatment, PASI 75, PASI 90, and PASI 100 response rates were 72.6%, 58.1%, and 36.3% for patients rescued with brodalumab and 61.7%, 25.5%, and 5.4% for patients who continued ustekinumab, respectively (Figure 1) Figure 1. PASI rates in patients with inadequate responsea to ustekinumab rescued with brodalumab at week 16 or continuing on ustekinumab after week 16. PASI 75, 90, and 100, psoriasis area and severity index 75%, 90%, and 100% improvement; Q2W, every 2 weeks; sPGA, static physi- cian’s global assessment. aInadequate response was defined as a single sPGA score ≥3 or persistent sPGA score of 2 over ≥4 weeks. • At week 52, patients who were rescued with brodalumab demonstrated higher PASI 75, PASI 90, and PASI 100 response rates than those who continued ustekinumab, regardless of prior TNFα inhibitor treatment (Figure 2) Figure 2. PASI rates at week 52 in patients with inadequate response to ustekinumab rescued with brodalumab 210 mg Q2W at week 16 or continuing on ustekinumab after week 16, analyzed by previous TNFα inhibitor experience. Observed analysis. N1, number of patients who had a valid measurement at week 52; PASI 75, 90, and 100, psoriasis area and severity index 75%, 90%, and 100% improvement; Q2W, every 2 weeks; TNFα, tumor necrosis factor α. Efficacy of Brodalumab vs Ustekinumab by Prior TNFα Inhibitor Exposure: Post hoc Analysis of Two Phase 3 Psoriasis Studies Alan Menter,1 Erin Boh,2 George Michael Lewitt,3 Abby Jacobson4 1Baylor University Medical Center, Dallas, TX; 2Tulane University School of Medicine, New Orleans, LA; 3Illinois Dermatology Institute, Chicago, IL; 4Ortho Dermatologics (a division of Bausch Health US, LLC), Bridgewater, NJ OBJECTIVE • To evaluate the efficacy of brodalumab vs ustekinumab (an anti–interleukin-12/-23 monoclonal antibody) in individuals who were rescued with brodalumab or continued ustekinumab, stratified by prior treatment with tumor necrosis factor α (TNFα) inhibitors, in a post hoc analysis of two phase 3 studies (AMAGINE-2/-3) CONCLUSIONS • Patients with psoriasis who were rescued with 36 weeks of retreatment with brodalumab demonstrated higher response rates than those who continued ustekinumab, regardless of prior TNFα inhibitor treatment • Brodalumab may be a safe and effective treatment after inadequate response to previous biologics Funding: This study was sponsored by Ortho Dermatologics. Medical writing support was provided by MedThink SciCom and funded by Ortho Dermatologics. Ortho Dermatologics is a division of Bausch Health US, LLC. Author disclosures: AM reports receiving compensation from or serving as an investigator, consultant, advisory board member, or speaker for AbbVie, Allergan, Amgen, Anacor Pharmaceuticals, Boehringer Ingelheim, Celgene Corporation, Dermira, Eli Lilly, Galderma, Janssen Biotech, LEO Pharma, Merck & Co., Neothetics, Novartis AG, Pfizer, Regeneron, Symbio/Maruho, Vitae, and Xenoport. EB reports serving as an investigator/member of a speakers bureau for and/or receiving grants from AbbVie, Actelion, Celgene, Elorac, Incyte, Janssen, Novartis, Ortho Dermatologics, Pfizer, Regeneron, Soligenix, SUN Pharmaceutical, and UCB; except for SUN Pharmaceutical, investigation and grant support payments were made to the Tulane University School of Medicine. GML reports partnership/ownership with Illinois Dermatology Institute (The Chicago Loop) and reports receiving grants/research support from and/or serving on a speakers bureau for AbbVie, AoBiome, Galderma, Janssen, Lilly, Novartis, Ortho Dermatologics, Sol-Gel, and UCB. AJ is an employee of Ortho Dermatologics (a division of Bausch Health US, LLC). Previous presentation information: Data included in this poster have been previously presented in part at the 76th Annual Meeting of the American Academy of Dermatology; February 16-20, 2018; San Diego, CA; and Maui Derm For Dermatologists; January 25-29, 2020; Maui, HI. References: 1. Siliq [package insert]. Bausch Health US, LLC; 2017. 2. Lebwohl et al. N Engl J Med. 2015;373:1318-1328. Presented at Fall Clinical Dermatology Conference • October 21-24, 2021 • Las Vegas, NV Sponsored by Ortho Dermatologics, a division of Bausch Health US, LLC. 16 32 52 16 32 52 16 32 52 0 20 40 60 80 100 Re sp on de rs , % Study week PASI 100 0 20 40 60 80 100 Re sp on de rs , % Study week PASI 90 0 20 40 60 80 100 Re sp on de rs , % Study week PASI 75 Rescued with brodalumab 210 mg Q2W after inadequate response to ustekinumab at week 16 (N=124); 36 weeks of brodalumab therapy Continued on ustekinumab after inadequate response after week 16 (n=149); 52 weeks of continuous ustekinumab 72.6 61.7 58.1 25.5 36.3 5.4 70.9 71.4 50.0 33.7 25.0 13.3 0 20 40 60 80 100 No prior TNF TNF nonfailure TNF failure Re sp on de rs , % PASI 90 88.6 92.9 58.3 75.3 70.8 53.3 0 20 40 60 80 100 No prior TNF TNF nonfailure TNF failure Re sp on de rs , % PASI 75 Responded to prior TNFα inhibitor treatment No prior TNFα inhibitor experience No prior TNFα inhibitor experience Failed prior TNFα inhibitor treatment N1= 79 1289 1514 24 Responded to prior TNFα inhibitor treatment Failed prior TNFα inhibitor treatment 45.6 42.9 25.0 7.9 4.2 0 0 20 40 60 80 100 No prior TNF TNF nonfailure TNF failure Re sp on de rs , % PASI 100 No prior TNFα inhibitor experience Responded to prior TNFα inhibitor treatment Failed prior TNFα inhibitor treatment Rescued with brodalumab 210 mg Q2W after inadequate response to ustekinumab at week 16; 36 weeks of brodalumab therapy Continued on ustekinumab after inadequate response after week 16; 52 weeks of continuous ustekinumab