ABSTRACT
Interleukin (IL)-17 is important in the pathophysiology of psoriasis and has proven to be an effective therapeutic target. Brodalumab, the third commercially available IL-17 antagonist, was approved by the US FDA in February 2017 for the treatment of moderate-tosevere plaque psoriasis. As brodalumab enters the marketplace, it is imperative to investigate its safety profile. We conducted a safety assessment of brodalumab using publically available adverse event data from phase II and III clinical trials. The most common adverse events were nasopharyngitis, upper respiratory tract infection, and candidiasis. The FDA issued a black box warning after six patients treated with brodalumab across four clinical trials committed suicide, but no causal relationship was identified. Current evidence suggests a similar safety profile for brodalumab compared to other IL-17 antagonists used to treat moderate-to-severe plaque psoriasis.
Subject(s)
Adverse Drug Reaction Reporting Systems/statistics & numerical data , Antibodies, Monoclonal/therapeutic use , Dermatologic Agents/therapeutic use , Psoriasis/drug therapy , Antibodies, Monoclonal/adverse effects , Antibodies, Monoclonal, Humanized , Clinical Trials as Topic , Dermatologic Agents/adverse effects , Humans , United StatesABSTRACT
OBJECTIVE: Anti-cyclic citrullinated peptide (CCP) antibody is an established marker in the diagnosis and prognostication of rheumatoid arthritis (RA). Infrequently, systemic lupus erythematosus (SLE) patients also develop a deforming erosive arthritis, similar to that of RA. Our objective was to determine whether anti-CCP antibody is a useful marker of erosive disease in SLE patients presenting with arthritis. METHODS: Electronic databases EMBASE, MEDLINE and non-indexed MEDLINE citations were searched through April 11, 2014, using the outlined key terms. Studies meeting predefined inclusion and exclusion criteria were reviewed. Two reviewers independently assessed the quality of included articles using previously described criteria. The DerSimonian-Laird random effects model was used to calculate pooled sensitivity and specificity of anti-CCP antibody for erosive arthritis in SLE. RESULTS: Seven articles met inclusion and exclusion criteria. A total of 609 SLE patients with arthritis were identified, 70 of whom had erosive disease. Pooled sensitivity and specificity of anti-CCP antibody for erosive arthritis was 47.8% (95% CI, 26.2%-70.2%) and 91.8% (95% CI, 78.4%-97.2%), respectively. CONCLUSION: Our findings suggest that anti-CCP antibody is a highly specific marker for erosive arthritis in SLE. Longitudinal prospective studies are needed to determine if anti-CCP antibody can be used as a predictor of erosive disease.
