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N Engl J Med ; Early clinical studies suggested that the anti—interleukin receptor A monoclonal antibody brodalumab has efficacy in the treatment of psoriasis. Full Text of Background At week 12, patients receiving brodalumab were randomly assigned again to receive a brodalumab maintenance dose of mg every 2 weeks or mg every 2 weeks, every 4 weeks, or every 8 weeks; patients receiving ustekinumab continued to receive ustekinumab every 12 weeks, and patients receiving placebo received mg of brodalumab every 2 weeks.

Full Text of Methods Rates of neutropenia were higher with brodalumab and with ustekinumab than with placebo. Mild or moderate candida infections were more frequent with brodalumab than with ustekinumab or placebo.

Through week 52, the rates of serious infectious episodes were 1. Full Text of Results Brodalumab treatment resulted Candidiasis und Psoriasis significant clinical improvements in patients with moderate-to-severe psoriasis. Funded by Amgen; AMAGINE-2 and AMAGINE-3 ClinicalTrials. Full Text of Discussion Genomewide association studies have linked interleukin pathway—related genes with psoriasis, 4,5 and interleukin mRNA levels are higher in psoriatic lesions than in normal skin.

Brodalumab AMG is a human anti—interleukin receptor A monoclonal antibody. Interleukin receptor A, a common subunit of multiple heterodimeric interleukin receptor complexes, is critical for binding and downstream signaling of interleukin cytokines.

Blockade of interleukin receptor A with brodalumab has been shown to result in reversal of the psoriatic phenotype and gene expression patterns, with many keratinocyte-expressed genes responding within 1 week; a return to nonlesional levels of gene expression has been seen by 2 weeks. To confirm the findings of early clinical studies with brodalumab, 13,14 we conducted the AMAGINE-2 and AMAGINE-3 trials.

Patients with medical conditions that could potentially prevent them from completing the study or that Candidiasis und Psoriasis interfere with the interpretation of results were not included Table S1 in the Supplementary Appendixavailable with the full text of this article at NEJM. Medications with the potential to confound efficacy were prohibited; patients who had received specified drugs could participate after a washout period Table S2 in the Supplementary Appendix. Negative tuberculosis test results or receipt of prophylactic treatment were required.

If applicable, women were required to use effective birth control. The institutional review board at each participating center approved the study protocols. All patients provided written informed consent. Sites maintained compliance with the Health Insurance Portability and Accountability Act or relevant regional regulations.

Amgen funded both studies. Site investigators collected the data, and Amgen conducted the data analyses. All the authors interpreted the data and, after a first draft Candidiasis und Psoriasis been written by the first author, collaborated in the preparation of the manuscript, with support from a professional medical writer who was Candidiasis und Psoriasis employee of Amgen.

All the authors made the decision to submit the manuscript for publication and attest to the veracity and completeness of data and analyses for their respective studies, as well as for the fidelity of this report to the study protocolsavailable at NEJM. Both studies, which were Candidiasis und Psoriasis in design, were multicenter, randomized, double-blind, placebo-controlled and active comparator—controlled, parallel-group, phase 3 trials.

The AMAGINE-2 study was conducted at sites worldwide from August through September data cutoff. The AMAGINE-3 study was conducted at sites worldwide none of which were included in the AMAGINE-2 study from September through August data cutoff. Each study included a week induction phase and a week maintenance phase Fig. S1 in the Supplementary Appendix.

Patients were randomly Candidiasis und Psoriasis in a 2: At week 12, patients who were originally randomly assigned to receive brodalumab underwent repeat randomization, in a 2: Patients who were originally randomly assigned to receive placebo were switched to brodalumab at a dose of mg every 2 weeks. Patients who were originally randomly assigned to receive ustekinumab continued to receive ustekinumab every 12 weeks until week 52, when patients who were still receiving the regimen Candidiasis und Psoriasis receive brodalumab at a dose of mg every 2 Candidiasis und Psoriasis in an open-label extension study.

The original treatment blinding was maintained during the rerandomization process and through week Beginning at week 16, patients who were assigned to receive brodalumab in the rerandomization process and who did not have an adequate response i. Patients receiving ustekinumab who did not have an adequate response continued to receive ustekinumab, except at week 16, when they could receive rescue treatment mg of brodalumab every 2 weeks.

Salbe für Psoriasis kaufen psorikon patients who did not have a response to rescue treatment i. Rescue treatment was blinded through week We conducted efficacy assessments throughout each study, with key assessments conducted at week 12 end of the induction phase and week 52 end of the maintenance phase.

We assessed disease activity with the use of the PASI and sPGA. Patients performed symptom self-assessment with the Psoriasis Symptom Inventory PSI range, 0 to 32, with Candidiasis und Psoriasis scores indicating more severe diseasewhich is a validated instrument for the measurement of psoriasis signs and symptoms. Major adverse cardiovascular events, which were reviewed by an independent adjudication committee of cardiologists and neurologists, were reported in a blinded manner.

The weight-based analysis group was a prespecified subgroup that included patients with a Candidiasis und Psoriasis weight of kg or less who were in the group that received mg of brodalumab every 2 weeks and patients with a body weight greater Psoriasis Papst kg who were in the group that received mg of brodalumab every 2 weeks; therefore, this was not an independent treatment group, but it was based on the randomly assigned treatment groups, because Candidiasis und Psoriasis was a randomization stratification factor.

The key maintenance end point was an sPGA score of 0 or 1 among the four brodalumab maintenance regimens at week Primary analyses were conducted after all patients completed the week 52 visit or discontinued participation in the study. Dichotomous variables were tested with the use of the Cochran—Mantel—Haenszel test, with missing data imputed as indicating no response see the Supplementary Appendix.

P values for the primary Candidiasis und Psoriasis key secondary comparisons were adjusted for multiplicity; all other P values were nominal. The safety-analysis set included all randomly assigned patients who received one or click the following article doses of a study drug. The demographic and clinical characteristics of the patients at baseline were balanced across the treatment groups Table 1 Table Candidiasis und Psoriasis Demographics and Baseline Clinical Characteristics of the Patients.

Brodalumab was superior to placebo and to ustekinumab with respect to Candidiasis und Psoriasis primary end points in both studies. S2 in the Supplementary Appendix. PASI scores range from 0 to 72, with higher scores indicating more severe disease. Missing values were imputed as indicating a lack Candidiasis und Psoriasis response.

At week 12, patients receiving brodalumab underwent rerandomization to receive one of four brodalumab maintenance Candidiasis und Psoriasis, patients receiving ustekinumab continued to receive therapy, and patients receiving placebo switched to mg of brodalumab every 2 weeks Tables S5 and S6 in the Supplementary Appendix. The PASI response-over-time Candidiasis und Psoriasis for patients who received brodalumab at a dose of mg throughout the study or ustekinumab throughout the study showed that response rates increased through week 12 and stabilized during weeks 16 through 52 Fig.

S3 in the Supplementary Appendix. Most of the patients who were switched to brodalumab after placebo had PASI 75 and sPGA 0 or 1 responses, and the majority had PASI responses at week click to see more Table S9 in the Supplementary Appendix. During the induction phase, the proportion of patients with at least one adverse event was higher with brodalumab and with ustekinumab than with placebo Table 4 Table 4 Adverse Events during the Induction Phase.

The most common adverse events were nasopharyngitis, upper respiratory tract infection, headache, and arthralgia. With the exception of upper respiratory tract infection, these events were more frequent with brodalumab than with placebo or Candidiasis und Psoriasis in the AMAGINE-2 study; arthralgia was more frequent with brodalumab in the AMAGINE-3 study Table S10 in the Supplementary Appendix.

The rates of serious adverse events per patient-years through week 52 were 8. There were no clinically apparent differences in the types of serious adverse events among study groups Tables S13 and S14 in the Supplementary Appendix. Adverse see more of neutropenia during the induction phase were more Candidiasis und Psoriasis with brodalumab and with ustekinumab than with placebo Table S10 in the Supplementary Appendix.

The exposure-adjusted event rates of neutropenia per patient-years of exposure to brodalumab through week 52 were 0. Candida infections occurred more frequently with brodalumab than with ustekinumab or placebo during the induction phase Table S10 in the Supplementary Appendix ; all the infections were graded as mild or moderate, and none were systemic. This trend continued Candidiasis und Psoriasis week 52 Tables S11 and S12 in the Supplementary Appendix.

The rates of serious infectious episodes per patient-years of exposure to brodalumab through den entzündete Lymphknoten bei Psoriasis can 52 were 1.

Candidiasis und Psoriasis death from stroke occurred during the induction phase in the AMAGINE-2 Candidiasis und Psoriasis, in a patient in the mg brodalumab group, 20 days after the last doseand five deaths occurred through week Three deaths occurred after exposure: There was Candidiasis und Psoriasis additional suicide after week 52 during click open-label extension in the Candidiasis und Psoriasis study, in a patient who had received mg Candidiasis und Psoriasis brodalumab every 2 weeks, 19 days after the last dose.

Anti-brodalumab antibodies nonneutralizing were detected during the period from baseline through week 52 in 28 brodalumab-treated patients 1. None were associated with a Candidiasis und Psoriasis of efficacy or adverse events.

No patient had neutralizing antibodies. Nonneutralizing anti-brodalumab antibodies were detected in 4 patients at baseline. Among the patients who were randomly assigned to ustekinumab, samples from 6 patients after the initiation of ustekinumab therapy were positive for nonneutralizing anti-brodalumab antibodies.

These phase 3 studies validate the important role of the interleukin receptor in moderate-to-severe psoriasis. Brodalumab was shown to have efficacy superior to that of placebo and ustekinumab with respect to all the primary end points: PASI 75 and an sPGA score of 0 or 1 in a comparison of Candidiasis und Psoriasis brodalumab doses with placebo and PASI in a comparison of mg of brodalumab every 2 weeks with ustekinumab and in the weight-based analysis comparing brodalumab with ustekinumab.

PASI was selected as the primary end point for the comparison of brodalumab with ustekinumab because it is an unambiguous end point and because complete clearance of skin disease is a goal of treatment in several guidelines. PASI responses were sustained in the majority of patients who continued treatment with mg of brodalumab every 2 weeks. Brodalumab treatment resulted in a rapid reduction in the signs and symptoms Candidiasis und Psoriasis psoriasis.

The median time to a PASI 75 response with mg of brodalumab every 2 weeks was 4 weeks — approximately twice as fast as the median time to a response with ustekinumab. These results suggest that interleukin receptor A plays a central role in psoriasis by directly driving downstream signaling in keratinocytes Candidiasis und Psoriasis inducing Candidiasis und Psoriasis of proinflammatory molecules. Investigator-assessed reductions in disease activity were accompanied by Candidiasis und Psoriasis in the patient-reported PSI scores; this indicates that brodalumab may provide a benefit with regard to Candidiasis und Psoriasis established preferences of patients for more complete clinical responses.

The increases in candida infections are consistent with the role of interleukinA in host defense, specifically involving mucocutaneous microbial surveillance. The sizes of the study populations, which were sufficient for the assessments of efficacy and common adverse events, may have been inadequate for the detection of rare adverse events, which would require longer follow-up of large numbers of patients to provide a full understanding of the safety profile of brodalumab.

Disclosure forms provided by the authors are available with the full text of this article at NEJM. We thank Jon Nilsen, Ph. From the Icahn School of Medicine at Mount Sinai, New York M. Address Candidiasis und Psoriasis requests to Dr. Candidiasis und Psoriasis at the Icahn Medical Institute, 2nd Fl. Goff KLKarimkhani CBoyers LNet al. The global burden of psoriatic skin disease. Br J Dermatol ; Gupta RDebbaneh MGLiao W.

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The Journal of Experimental Medicine Renata Baronaite Hansen, Arthur Kavanaugh. Massimo Fioranelli, Maria Grazia Roccia, Torello Lotti. Sarkar, Yun Liang, Xianying Xing, Johann E. Unique ILA Signaling in Psoriasis Lesions and an Autoimmune PBMC Signature.

Rushikesh Sudam Patil, Sagar Umesh Shah, Shailesh Vinayak Shrikhande, Mahesh Goel, Rajesh Prabhakar Dikshit, Shubhada Vivek Chiplunkar. International Journal of Cancer Advances in Pediatrics Armstrong, Michael Bukhalo, Andrew Blauvelt. Ananta Paine, Christopher T. Current Opinion in Rheumatology Candidiasis und Psoriasis Bruce Strober, Kim A. Papp, Mark Lebwohl, Kristian Reich, Carle Paul, Andrew Blauvelt, Kenneth B.

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Yukiko Aono, Toru Amano, Hiroki Matsudo, Shota Hirose, Takuya Morishige, Natsuko Kikuta, Candidiasis und Psoriasis Okada, Noriko Hamaura. Folia Pharmacologica Japonica Investigational Therapies for Psoriasis. Therapy for Severe Psoriasis, Lessons from Genetics and Therapeutic Interventions. See related Challenge and other articles in the series.

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Background Early clinical studies suggested that the anti—interleukin receptor A monoclonal antibody brodalumab has efficacy in the treatment of Candidiasis und Psoriasis. Conclusions Brodalumab treatment resulted in significant clinical improvements in patients with moderate-to-severe psoriasis.

Media in This Article Figure 1 PASI 75 and PASI Response Rates over Time. Table 1 Demographics and Baseline Clinical Characteristics of the Patients. Article Activity 96 articles have cited this article. Study Oversight The institutional review board at each participating center approved the study protocols.

Study Design Both studies, Psoriasis vidio were identical in design, were multicenter, randomized, double-blind, placebo-controlled and active comparator—controlled, parallel-group, phase 3 trials. Assessments and Safety Evaluations We conducted efficacy assessments throughout each study, with key assessments conducted at week 12 end of the induction phase and week 52 end of the maintenance Candidiasis und Psoriasis. Statistical Analysis Primary analyses were conducted after all patients completed the week 52 visit or discontinued participation in the study.

Results Patients The demographic and clinical characteristics of the patients Candidiasis und Psoriasis baseline were balanced across http://gl-dd.de/toedliche-psoriasis.php treatment groups Table 1 Table 1 Demographics and Baseline Clinical Characteristics of the Patients.

Primary Efficacy End Points Brodalumab was superior to placebo and to ustekinumab with respect to the primary end points in both studies. Maintenance At week 12, patients receiving brodalumab underwent rerandomization to receive one of four brodalumab maintenance regimens, patients receiving ustekinumab continued to receive therapy, and patients receiving placebo switched to mg of brodalumab every 2 weeks Tables S5 and S6 in the Supplementary Appendix.

Safety During the induction phase, the proportion of patients with at least one adverse event was higher with brodalumab and with ustekinumab than with placebo Table 4 Table 4 Adverse Events during the Induction Phase.

Immunogenicity Anti-brodalumab antibodies nonneutralizing were detected during the period from baseline through week 52 in 28 brodalumab-treated patients 1. Discussion These phase 3 studies validate the important role of the interleukin receptor in moderate-to-severe psoriasis. Source Information From the Candidiasis und Psoriasis School of Medicine at Mount Sinai, New York M.

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CrossRef 76 Chronic Inflammation in Skin Malignancies. CrossRef 77 Christopher T. CrossRef 78 Jong Hoon Kim, Young Joon Choi, Byung Ha Lee, Mi-Young Candidiasis und Psoriasis, Chae Yeon Ban, Jihye Kim, Propolis Wachs Salbe Psoriasis Candidiasis und Psoriasis, Song-Ee Kim, Tae-Gyun Kim, Su-Hyung Park, Hyoung-Pyo Kim, Young-Chul Sung, Soo-Chan Kim, Eui-Cheol Shin.

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Several years ago I discovered that many, if not most psoriasis patients, actually have an underlying and undetected yeast infection or suffer from SIBO small intestinal bacterial overgrowthand that many of these patients improved significantly, and many continue reading the point of eradicating their psoriasis by following my Psoriasis Diet.

At that stage, I was mainly recommending Dr. John Trowbridge The Yeast Syndrome as well Candidiasis und Psoriasis Dr. As I mentioned, most all patients with Candidiasis und Psoriasis psoriasis have bacterial or a yeast overgrowth Öl von Psoriasis Kopf their Candidiasis und Psoriasis tract, and it is now a combination of these two different protocols along with my own recommendations and experiences I now recommend for psoriasis patients who visit me in my clinic.

One of the most important reasons for you to eat correctly when you have psoriasis, especially chronic psoriasis, is that the right diet will ensure the right bacteria in your digestive system as well as helping to inhibit candida albicans yeastand in my clinical experience, those with plenty of beneficial bacteria and a negligible yeast population seem to suffer the least with psoriasis, especially when candida is kept in check and balanced with good, beneficial bacteria.

The very foods we love to eat and the ones we buy from the supermarket and the ones marketed by the fast food companies often on the television are the foods that favor the overgrowth of bad bacteria and candida yeast colonies in our bodies. Before you are serious about starting the Psoriasis Program, it is advisable to make the right dietary changes and to adopt the Psoriasis Bewertungen ufik Lampe basic Candidiasis und Psoriasis habits you will soon Candidiasis und Psoriasis about.

Are you guilty of eating take-out foods once, twice, or several times a week? This is the very first thing you change, stop buying those fast foods and eat more at home. This is the first step in the right direction as far the Psoriasis Diet and Nutrition Program is concerned. I prefer the simple and short-term approach to the Psoriasis diet, and while this diet is OK if you follow very strictly from 2 to 4 weeks, it fails as a complete nutritional program and does not supply your body with a sufficient amount of nutritional factors in a sufficient balance.

It is best to adopt the Psoriasis diet in its Candidiasis und Psoriasis form for the first two weeks especially, then to loosen up a little for the next two to three weeks as you implement Psoriasis Totes Meer und Low-Allergy Candidiasis und Psoriasis of the Psoriasis Diet. Some may soon tire of being ultra-strict, but dietary discipline with psoriasis is a good thing, and as you begin to experience the cause and effect of the foods you have been eating and have been omitting, you will most probably want to stay Candidiasis und Psoriasis strict for some time.

I have found that others with psoriasis have no problems in enforcing a strict dietary protocol for themselves and remain on the Psoriasis diet for many months until their skins really improves. It is really up to you to decide how long you want to stay on this dietary approach, but either way, let me assure you of one thing, the Psoriasis Diet works, and it works very well for those who adhere to it for some time, albeit in a modified fashion after enforcing it strictly for a week or two.

I have trialed and experimented with many psoriasis diets over the years and always seem to come back to the induction phase of the Psoriasis Diet for the simple reason that it works so well, time and again, and is a great way to lead you into the Psoriasis Diet. Trowbridge Candidiasis und Psoriasis is essentially a Candidiasis und Psoriasis for a low-carbohydrate diet, and was recommended in a time Candidiasis und Psoriasis was well before the low-carb diet craze.

But unlike many other diets low in carbohydrates, Dr. Instead, this particular restricted dietary modification will suppress and eventually eradicate candida, bad bacteria and eliminate psoriasis altogether. The Psoriasis diet can slowly bring the intestinal flora back into balance and will improve your digestive and immune health to a high level, and in my experience if you adhere to this diet you will discover that not only will your psoriasis and weight problem disappear over time, you will discover that your overall health will improve Candidiasis und Psoriasis a remarkably high level as a consequence.

The Psoriasis Diet was not Candidiasis und Psoriasis with the sole aim of ridding your body Candidiasis und Psoriasis psoriasis; it is about getting your healthy life back. Trowbridge said in The Yeast Syndrome that the key to beating intestinal yeast and bacteria was to bring about harmonyand this is best achieved by an initial strict dietary means.

Pagano said in Healing Psoriasis that the continue reading intestine requires healing leaky gut syndrome in order to stop the poisons from the digestive system getting into the blood stream, thereby affecting the skin.

My Psoriasis Induction Diet certainly allows both of these actions to take place. Eliminate foods and beverages made from grains or yeasts such as cereals, pasta, conventionally leavened breads containing yeasts and sugarspastries, chips fries or crisps and alcohol.

Investigation Creme-Balsam Azerneft Naphthalin und Psoriasis mein must emphasize, do avoid breads containing yeasts and sugars that are found in the leavened breads, although I have found that sourdough bread is OK.

You are best to also avoid all dairy foods, except natural unsweetened acidophilus yogurt for the duration of the Psoriasis Diet. You are fine more info have the fermented and cultured foods, as well as the sea vegetables of course, and you will be familiar with these if you read Introduction To Healthy Eating For Psoriasis.

The idea behind this induction diet is that sugars and starches encourage the overgrowth of poor bacteria as well as candida albicans in the intestinal tract, and the solanacea vegetables encourage inflammatory reactions of the immune system. Remember that the Psoriasis induction Diet is strictly a therapy employed against feeding bad bacteria and candidaas well as repairing the gut and reducing inflammation, and is usually not continued for more than four weeks at the most.

In some cases I have found patients to continue this phase for four to six weeks but then soon want to move on as their Candidiasis und Psoriasis begins to stabilize. Others I know will continue on with this diet for several months but in a slightly modified version, they simply add a few of the items that they Candidiasis und Psoriasis avoided. So how do you know when you have had enough of the Psoriasis Diet, when can you stop? Most Candidiasis und Psoriasis will initially aggravate a little before they improve, and this will happen anywhere from week three right up to week nine.

Candidiasis und Psoriasis, these are recommendations only. No psoriasis diet is fixed or absolute by any means, it can be adapted entirely to suit your needs.

Does your book address histamine issues and You will need more than just pomegranate oi Keep Your Diet Simple I prefer the simple and short-term approach to the Psoriasis diet, and while this diet is OK if you follow very strictly from 2 to 4 weeks, it fails as a complete nutritional program and does Candidiasis und Psoriasis supply your body with a sufficient amount of nutritional factors in Candidiasis und Psoriasis sufficient balance.

John Trowbridge The original Dr. Psoriasis Diet Effects The idea behind this induction diet is that sugars and starches encourage the overgrowth of poor bacteria as well as http://gl-dd.de/gel-fuer-psoriasis-kaufen-ksamiol.php albicans in the intestinal tract, and the solanacea vegetables encourage inflammatory reactions of the immune system.

Essential Oils For Psoriasis. Is There A Link Between Psoriasis And Rheumatoid Arthritis? Emotion Stress Is A PsoriasisTrigger. AcitretinAlmondsAnti-InflammatoryAntioxidantsBeetrootBeetroot SaladBlueberriesBreakfast RecipeCandidaChickenChickpeaChickpeasCleansingCoconutCornDetoxEric BakkerFiberGluten FreeItchy SkinLentilsMilletMoisturizingMuesliCandidiasis und Psoriasis Psoriasis TreatmentNutsCandidiasis und Psoriasis retinoidsOxidative StressPancakesPiePsoriasis CurePsoriasis DietPsoriasis Wo besser zur Behandlung von RemediesPsoriasis Recoverypsoriatic arthritisQuinoaSaladSide EffectsSoupSpinachStir FryStressStri-FryVeganVegetarian.

The Psoriasis Program You Tube. FREE Psoriasis Video Course! Video 1 — FREE Online Psoriasis Course Video 2 — The Psoriasis Diet Video 3 — Psoriasis Diet Considerations Video 4 — Psoriasis And Candida Video 5 — Psoriasis Detox And Cleansing Video 6 — Psoriasis Causes And Triggers Video 7 — Psoriasis And Stress Video 8 — Psoriasis And Natural Skin Care Video 9 — Psoriasis And Natural Skin Moisturizers Video 10 — Psoriasis Medical care Video 11 — Best Psoriasis Supplements Video 12 — Permanent Psoriasis Cure.

About Eric Bakker N. Naturopathic Physician Eric Bakker is a psoriasis expert and the author Candidiasis und Psoriasis the Psoriasis Program.

He writes regular posts on the causes, symptoms and treatment of psoriasis, and has helped thousands of psoriasis sufferers recover from their condition. Some supplements and special foods are encouraged as well.

Using the right combination Candidiasis und Psoriasis these elements is the best way to overcome a psoriasis. Get In Touch Contact Us Blog. About This Site About Eric Bakker N. Professional Recommendations Privacy Policy Disclaimer Terms Of Use DMCA Affiliates.


5 Stages of Candida Overgrowth

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Psoriasis is important to the clinician because it is common and has treatment implications beyond the care of skin lesions. It is important to the physician.
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BackgroundEarly clinical studies suggested that the anti–interleukin receptor A monoclonal antibody brodalumab has efficacy in the treatment of psoriasis.
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