April Armstrong,1 Mark Lebwohl,2 Linda Stein Gold,3 Abby Jacobson4
1University of Southern California, Los Angeles, CA; 2Icahn School of Medicine at Mount Sinai, New York, NY; 3Henry Ford Health System, West Bloomfield, MI; 4Ortho Dermatologics (a division of Bausch Health US, LLC), Bridgewater, NJ

Table 1. Median Times to Achieve Therapeutic Response (AMAGINE-2/-3)

• Brodalumab treatment was associated with greater proportions of PSI 
total responders (defined as weekly average PSI total score ≤8, with no 
item scores >1) and PSI itch responders (defined as weekly average PSI 
itch score ≤1; P<0.0001) vs ustekinumab, indicating a rapid reduction in 
patient-reported symptom severity (AMAGINE-2/-3; Figure 2)8

 – Additionally, a significantly greater proportion of patients treated with  
brodalumab vs ustekinumab achieved a PSI total score of 0 at week 12 (22.7% 
vs 13.4%; P<0.001)8

Figure 2. Brodalumab treatment was associated with a faster onset of 
symptom improvement, assessed via proportion of PSI responders, vs 
ustekinumab8 in AMAGINE-2/-3 for (A) PSI total score and (B) PSI itch score.  

PSI, psoriasis symptom inventory. aDefined as weekly average PSI total score ≤8, with no item scores >1.  
bDefined as weekly average PSI itch score ≤1. *P<0.0001.

• Significant improvements in quality-of-life measures (≥5-point DLQI 
improvement from baseline) were seen as early as week 2 among patients 
treated with brodalumab vs placebo (P<0.001; AMAGINE-1/-2/-3; Figure 3)9

 – Furthermore, complete skin clearance with brodalumab was associated with 
greater improvements in DLQI; 60.9% of patients who achieved PASI 100  
attained a DLQI score of 0 at week 12, vs 20.5% of patients who achieved  
PASI 75 to <905,9

Figure 3. Patients treated with brodalumab experienced rapid improvement 
in quality of life in AMAGINE-1/-2/-3. 

DLQI, dermatology life quality index. *P<0.001.

Indirect comparison of brodalumab and other psoriasis 
biologics
• In an indirect comparison, brodalumab treatment resulted in faster time to 

response (mean time for 50% of patients to achieve PASI 90) than other 
psoriasis biologics, including ixekizumab and secukinumab (6.2 vs 7.4 and 
16.3 weeks, respectively; Table 2)6

Table 2. Indirect Comparison of Time to Response6

Brodalumab Provides 
Rapid Onset of  
Therapeutic Response 
for Patients With 
Moderate-to-Severe 
Psoriasis

OBJECTIVE
• To characterize the time to response 

of brodalumab by directly comparing 
brodalumab with ustekinumab or 
placebo in clinical studies and by 
indirectly comparing brodalumab with 
other psoriasis biologics 
 

CONCLUSIONS
• Onset of response was more rapid than 

other psoriasis biologics in direct and 
indirect comparisons

• Brodalumab provides a safe and effective 
treatment option, with rapid onset of 
symptom relief and improvements in 
quality of life, for adult patients with 
moderate-to-severe psoriasis

SYNOPSIS
• Several factors should be considered when selecting the most appropriate 

treatment of moderate-to-severe psoriasis, including drug effectiveness, potential 
adverse events, and time to response1

• The human anti–interleukin-17 receptor A monoclonal antibody brodalumab has 
been shown to be safe and effective for moderate-to-severe psoriasis in adults 
and improves clinical outcomes more rapidly than other psoriasis biologics2

METHODS
• This post hoc analysis directly compares time to response of brodalumab 

vs ustekinumab or placebo in three phase 3 studies (AMAGINE-1/-2/-3), 
measured by the following: 

 – Psoriasis area and severity index (PASI) responses from baseline 
(AMAGINE-2/-3)3 

 – Psoriasis symptom improvement, assessed with the psoriasis symptom 
inventory (PSI; AMAGINE-2/-3); for the PSI, patients rank the severity of 8 
symptoms (itch, redness, scaling, burning, cracking, stinging, flaking, and pain) on 
a 5-point scale ranging from 0 (not at all) to 4 (very severe), and individual item 
scores are combined for a total score ranging from 0 to 324 

 – Changes in patient-reported quality of life, assessed with the dermatology life 
quality index (DLQI; AMAGINE-1/-2/-3)5 

• Time to onset of therapeutic response of brodalumab is also indirectly 
compared with that of other psoriasis biologics6

RESULTS
Clinical studies of brodalumab (AMAGINE-1/-2/-3)
• Significant differences in speed of efficacy between brodalumab and 

ustekinumab were seen as early as week 1, in which 3.5% of brodalumab-
treated patients achieved ≥75% reduction from baseline in PASI (PASI 75), 
vs 0.2% of ustekinumab-treated patients (P<0.001; AMAGINE-2/-3; Figure 1)3

 – Median times to achieve PASI 25, PASI 50, or PASI 75 (Table 1) and median 
times for 50% of patients to achieve PASI 75, PASI 90, or PASI 100 were 
significantly shorter with brodalumab vs ustekinumab (P<0.001 for all analyses)3,7

Figure 1. PASI 75 responders through week 12 among patients treated with 
brodalumab or ustekinumab in AMAGINE-2/-3.3 

PASI 75, ≥75% reduction from baseline in psoriasis area and severity index. *P<0.001.

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: AA, ML, and LSG report the following financial disclosures related to the 
presentation: serving as a research investigator, speaker, or scientific advisor for Ortho Dermatologics (a 
division of Bausch Health US, LLC). AJ is an employee of Ortho Dermatologics (a division of Bausch Health 
US, LLC).

References: 1. Thibodeaux et al. SKIN The Journal of Cutaneous Medicine. 2019;3:368-373. 2. Lebwohl et al.  
N Engl J Med. 2015;373:1318-1328. 3. Blauvelt et al. J Am Acad Dermatol. 2017;77:372-374. 4. Gordon et al.  
Br J Dermatol. 2014;170:705-715. 5. Wu. Am J Manag Care. 2017;23(21 suppl):S403-S416. 6. Egeberg et al. J Eur 
Acad Dermatol Venereol. 2020;34:39-46. 7. Blauvelt et al. Slides presented at: Annual Meeting of the American 
Academy of Dermatology; March 3-7, 2017; Orlando, FL. 8. Gottlieb et al. J Eur Acad Dermatol Venereol. 
2018;32:1305-1313. 9. Data on file, Ortho Dermatologics (a division of Bausch Health US, LLC).

Previous presentation information: Data included in this poster have been previously presented in full at 
the 2nd Annual Innovations in Dermatology Fall Conference; November 3-5, 2022; Virtual and Las Vegas, NV.

 

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Presented at Winter Clinical Dermatology Conference - Hawaii ® • January 13-18, 2023 • Kohala Coast, HI

##

 

Median time, weeks
Brodalumab 

(n=1236)
Ustekinumab 

(n=613) P value
Time to achieve PASI 75 4.2 9.4 <0.0001

Time to achieve PASI 50 1.8 4.5 <0.0001

Time to achieve PASI 25 0.8 1.8 <0.0001
PASI 25, 50, and 75, ≥25%, ≥50%, or ≥75% reduction from baseline in psoriasis area and severity index.

Proportion of patients 
achieving PASI, weighted 
mean (SD) time, weeks Brodalumab Ixekizumab Secukinumab
Time for 50% to achieve PASI 90 6.2a 7.4 (0.7) 16.3 (6.2)

Time for 25% to achieve PASI 100 6.9 (0.9) 8.1 (1.2) 15.1 (0.4)
PASI 90 and 100, ≥90% or 100% reduction from baseline in psoriasis area and severity index. aOnly one 
study cohort.