Subgroup Analysis Reveals Equal Benefit of Brodalumab in Obese vs Non-Obese Patients With Psoriasis

Brodalumab (Siliq; Bausch) demonstrates comparable efficacy and equal benefit in adult patients with psoriasis regardless of weight, according to a subgroup analysis published in the Journal of the European Academy of Dermatology and Venerology.¹

Data stems from a post hoc analysis of the LIBERO study.² Researchers reported similarities in treatment efficacy and lesion clearance in patients weighing less than 100 kg (220.5 lb) and greater than 100 kg.

Image Credit: © Milan Lipowski - stock.adobe.com

Background and Methods

The LIBERO study assessed the effectiveness and safety of brodalumab in routine clinical settings over 12 and 52 weeks. The open label, multicenter study enrolled 638 patients across 148 German sites, most with severe or very severe psoriatic disease.

Results showed significant improvements, with 74% achieving a Psoriasis Area and Severity Index (ASI) score of less than or equal to 3 by week 12 and further improvements by week 52, where 85.5% achieved a Physician’s Global Assessment (PGA) score of 0/1, and over half were completely clear (PGA0). Improvements began as early as 2 weeks into treatment.

The post hoc analysis aimed to evaluate the effectiveness of brodalumab in patients weighing less than or equal to 100 kg and more than 100 kg over at approximately 12 and 52 weeks, with a primary focus on achieving low PASI and PGA scores.

Findings

Out of 622 enrolled patients, 26.0% of non-obese and 36.0% of obese patients discontinued treatment, primarily due to insufficient response, side effects, or being lost to follow-up.

Obese patients, comprising 25.9% of participants, had a higher prevalence of males (81.4%) compared to non-obese patients (59.2%), alongside higher rates of hypertension, diabetes, and depression. Both groups had comparable psoriasis history and severity at baseline.

By week 12, both groups demonstrated significant reductions in PASI scores, indicating improved skin clearance. Non-obese patients demonstrated slightly better PASI 90/100 response rates compared to obese patients, although PASI 75 rates were similar.

By weeks 42 to 52, effectiveness outcomes, including PASI 0-3, PASI 90/100, and quality of life improvements, were sustained in both groups with no significant differences observed. Satisfaction with treatment remained high, though slightly lower in obese patients.

Conclusions

While short-term outcomes favored nonobese patients, long-term effectiveness and quality of life improvements were comparable across both weight categories. This indicates brodalumab’s efficacy regardless of obesity status, according to study authors von Kiedrowski et al.

The study's limitations include the absence of a control group and the inherent constraints of its observational design. Additionally, the comparison of weight categories included differences in sample sizes and patient characteristics between obese and non-obese groups, limiting statistical comparability.

"This subgroup analysis of LIBERO confirmed that brodalumab can be equally beneficial in obese and non-obese patients in long-term management of psoriasis—even in a more difficult-to-treat real-world patient population," wrote study authors.

References

1. von Kiedrowski R, Asadullah K, Korge B, Tsarovina K, Augustin M. Efficacy of brodalumab in psoriasis patients with a body weight >100 kg: real-world evidence (RWE) from the LIBERO study. J Eur Acad Dermatol Venereol. November 21, 2024. https://doi.org/10.1002/jvc2.556
2. von Kiedrowski R, Hinz T, Mauer G, et al. Management of moderate to severe psoriasis with brodalumab-Real-world evidence from the LIBERO study. J Eur Acad Dermatol Venereol. 2024;38(11):2156-2166. doi:10.1111/jdv.19974