A new study has assessed the impact of a switch from tumor necrosis factor-alpha (TNF-α) inhibition to interleukin (IL)-17 inhibition using brodalumab on symptoms of depression and anxiety in patients with psoriasis, of which generalized pustular psoriasis (GPP) is a form.

The study, published in the Journal of Dermatology, found significant improvements in the Psoriasis Area and Severity Index and in symptoms of depression, whereas anxiety symptoms were reduced in a nonsignificant manner.

“Several studies have assessed the rate of depression and depressive symptoms among psoriatic patients and concluded that there is a significantly higher prevalence of depressive symptoms in patients with psoriasis compared to healthy controls,” the authors wrote. “The present study showed improvement in psoriasis and mental well-being after a 12-week treatment of brodalumab, an interleukin-17 inhibitor.”

The research team conducted an open-label, randomized, parallel group phase 4 study in Sweden to assess the efficacy of brodalumab therapy on 20 patients with moderate to severe plaque psoriasis who had an inadequate response to TNF-α inhibitor treatment. Patients were randomized to receive brodalumab for 12 weeks or to continue with a TNF-α inhibitor for 12 weeks before receiving brodalumab.

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Psoriasis severity was assessed using the static Physician’s Global Assessment form, the Patient Global Assessment form, the Pruritus Visual Analogue Scale, and the Dermatology Life Quality Index survey. To assess depression and anxiety, the self-assessment version of the Montgomery-Asberg Depression Rating Scale and the Hospital Anxiety and Depression Scale were employed.

The results showed that the 3-month change in treatment had a positive effect on anxiety and depression in the patients, suggesting that IL-17 inhibition may improve depression and anxiety directly as well as indirectly through psoriatic relief. The authors recommend clinicians include depressive symptoms in the treatment regimen for their patients with psoriasis.


Andersch-Björkman Y, Micu E, Seifert O, Lonne-Rahm S-B, Gillstedt M, Osmancevic A. Effects of brodalumab on psoriasis and depressive symptoms in patients with insufficient response to TNF-α inhibitors. J Dermatol. Published online August 31, 2023. doi:10.1111/1346-8138.16917