In response to Lebwohl et al, “Psychiatric adverse events during treatment with brodalumab: Analysis of psoriasis clinical trials”

To the Editor: I would like to commend Lebwohl et al for their thorough and transparent analysis of the psychiatric adverse events associated with the brodalumab trials.1 One of the first systemic agents for psoriasis to be examined in a study enrolling a population with no specific psychiatrically related exclusion criteria, brodalumab in some ways fell victim to its own noble aims. In retrospect, it should not have been unexpected that a trial enrolling a large cohort of middle-aged white men with moderate-to-severe psoriasis, some of whom had additional suicide risk factors, resulted in several episodes of suicidal ideation and behavior (SIB).