Brodalumab vs. Ustekinumab: Head-to-Head Studies of Psoriasis Save

AMAGINE-2 and AMAGINE-3 are in two phase 3 studies that compare multiple doses of brodalumab (anti-IL-17) and ustekinumab (anti-12/23) in adults with moderate-to-severe psoriasis. For 12 weeks, patients were blindly assigned to either 210 mg or 140 mg brodalumab (every 2 weeks), ustekinumab (45 mg or 90 mg every 12 weeks), or placebo.

After week 12, brodalumab patients received a brodalumab 210 mg every 2 weeks or 140 mg every 2 weeks, every 4 weeks, or every 8 weeks; ustekinumab patients continued the same dose every 12 weeks, and placebo patients were changed to 210 mg of brodalumab every 2 weeks. At week 12, the PASI 75 response rates were higher with brodalumab (86% with 210-mg and 67% with 140-mg doses) compared with placebo (6-8%) or ustekinumab. The week 12 PASI 100 response rates were significantly higher with 210 mg of brodalumab than with ustekinumab (37-44% vs.19-22%). Rates of neutropenia and candidiasis were higher with brodalumab vs placebo or ustekinumab. Through week 52, the rates of serious infectious episodes were low and similar in all groups.

Hence, brodalumab treatment resulted in significantly better skin outcomes in patients with moderate-to-severe psoriasis.