Brodalumab as a Second-Line Therapy in Psoriasis: Rapid Response and Unique Mechanism of Action After Biologic Failure
Bibliographic record
Abstract
This narrative review evaluates the clinical evidence supporting brodalumab as a second-line therapy against moderate-to-severe plaque psoriasis in adults who have experienced prior systemic treatment failure. Despite advances in biologic therapy, treatment failure remains a substantial challenge, with patients often discontinuing initial biologic treatment owing to inadequate response. Here, we analyzed data from clinical trials, real-world studies, and observational research examining brodalumab's efficacy in treatment-experienced populations. Unlike other biologics that target specific interleukin 17 (IL-17) cytokines, brodalumab blocks the IL-17 receptor A and prevents signaling from multiple IL-17 family members, potentially explaining its effectiveness in treatment-resistant cases. The evidence presented here demonstrates rapid Psoriasis Area and Severity Index response rates, as well as durable efficacy of brodalumab in patients after a failed treatment with previous biologic therapies. This narrative review synthesizes the current evidence base for brodalumab's role specifically in the second-line setting, providing clinicians with a comprehensive assessment of its efficacy in treatment-resistant psoriasis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".