• Philip J Mease, Mark C Genovese, Maria W Greenwald, Christopher T Ritchlin, André D Beaulieu, Atul Deodhar, Richard Newmark, JingYuan Feng, Ngozi Erondu, and Ajay Nirula.
• From the Swedish Medical Center and University of Washington, Seattle (P.J.M.); Oregon Health and Science University, Portland (A.D.); Stanford University, Palo Alto (M.C.G.), Desert Medical Advances, Palm Desert (M.W.G.), and Amgen, Thousand Oaks (R.N., J.Y.F., N.E., A.N.) - all in California; University of Rochester Medical Center, Rochester, NY (C.T.R.); and Laval University, Quebec, QC, Canada (A.D.B.).
• N. Engl. J. Med.. 2014 Jun 12;370(24):2295-306.

BackgroundWe assessed the efficacy and safety of brodalumab, a human monoclonal antibody against interleukin-17 receptor A (IL17RA), in a phase 2, randomized, double-blind, placebo-controlled study involving patients with psoriatic arthritis.MethodsWe randomly assigned patients with active psoriatic arthritis to receive brodalumab (140 or 280 mg subcutaneously) or placebo on day 1 and at weeks 1, 2, 4, 6, 8, and 10. At week 12, patients who had not discontinued their participation in the study were offered open-label brodalumab (280 mg) every 2 weeks. The primary end point was 20% improvement in American College of Rheumatology response criteria (ACR 20) at week 12.ResultsOf the 168 patients who underwent randomization (57 in the brodalumab 140-mg group, 56 in the brodalumab 280-mg group, and 55 in the placebo group), 159 completed the double-blind phase and 134 completed 40 weeks of the open-label extension. At week 12, the brodalumab 140-mg and 280-mg groups had higher rates of ACR 20 than the placebo group (37% [P=0.03] and 39% [P=0.02], respectively, vs. 18%); they also had higher rates of 50% improvement (ACR 50) (14% [P=0.05] and 14% [P=0.05] vs. 4%). Rates of 70% improvement were not significantly higher in the brodalumab groups. Similar degrees of improvement were noted among patients who had received previous biologic therapy and those who had not received such therapy. At week 24, ACR 20 response rates in the brodalumab 140-mg and 280-mg groups were 51% and 64%, respectively, as compared with 44% among patients who switched from placebo to open-label brodalumab; responses were sustained through week 52. At week 12, serious adverse events had occurred in 3% of patients in the brodalumab groups and in 2% of those in the placebo group.ConclusionsBrodalumab significantly improved response rates among patients with psoriatic arthritis. Larger studies of longer duration are necessary to assess adverse events. (Funded by Amgen; ClinicalTrials.gov number, NCT01516957 .).

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