Brodalumab
Indications
Brodalumab is used for:
Moderate to severe plaque psoriasis
Adult Dose
Psoriasis
Indicated for moderate-to-severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy and have failed to respond or have lost response to other systemic therapies
210 mg SC at Weeks 0, 1, and 2, THEN
210 mg SC q2wk
If an adequate response has not been achieved after 12-16 weeks, consider discontinuing therapy; continued treatment beyond 16 weeks in patients who have not achieved an adequate response is not likely to result in greater success
Child Dose
Renal Dose
Administration
SC Preparation
Allow syringe to reach room temperature (~30 minutes) before injecting
Do not warm in any other way
Do not remove the gray needle cap on the prefilled syringe while allowing it to reach room temperature
Visually inspect for particles and discoloration prior to administration; should appear as a clear to slightly opalescent, colorless to slightly yellow solution; a few translucent to white, amorphous proteinaceous particles may be present
Do not use if solution is cloudy or discolored or if foreign matter is present
Instruct patients to use the prefilled syringe and to inject the full amount (1.5 mL), which provides 210 mg, according to the directions provided
SC Administration
Administer SC
Each prefilled syringe is for single dose only
Instruct patients to review the Medication Guide before use
Intended for use under the guidance and supervision of a healthcare professional
Patients may self-inject when deemed appropriate by a healthcare professional and after proper training in SC injection technique using the prefilled syringe
Advise patients who are self-administering to inject the full dose
Do not inject into areas where the skin is tender, bruised, red, hard, thick, scaly, or affected by psoriasis
Contra Indications
Hypersensitivity. Patients w/ serious infection & active TB.
Precautions
Increased risk of infections; may activate TB in patients w/ history of TB. Closely monitor for any signs of infection. Patients w/ depression, in a state of depression, or w/ history of suicidal ideation or suicidal attempt. Active Crohn's disease. Perform tests (eg, chest x-ray) regularly to closely monitor potential onset of TB during treatment. Malignant skin & non-skin tumors. Avoid concomitant use w/ live vaccines; another biologic; immunosuppressants or phototherapy. Pregnancy & lactation.
Pregnancy-Lactation
Pregnancy
There are no human data regarding use in pregnant women to inform a drug-associated risk
Human IgG antibodies are known to cross the placental barrier; therefore, brodalumab may be transmitted from the mother to the developing fetus
Lactation
Unknown if distributed in human breast milk
Detected in the milk of lactating cynomolgus monkeys
Consider the developmental and health benefits of breastfeeding along with the mother’s clinical need for the drug, and any potential adverse effects on the breastfed infant from the drug or from the underlying maternal condition
Interactions
Live vaccines.
Adverse Effects
Side effects of Brodalumab :
1-10%
Headache (3.5%)
Arthralgia (3.3%)
Fungal infections (2.4%)
Injection site reaction (1.3%)
Fatigue (1.1%)
Diarrhea (1.1%)
Oropharyngeal pain (1.1%)
Nausea (1.1%)
<1%
Serious infections (0.5%)
Influenza (0.5%)
Neutropenia (0.5%)
Tinea infections (0.2%)
Conjunctivitis
Candida infections
Mechanism of Action
Human monoclonal IgG2 antibody that selectively binds to human IL-17RA and inhibits its interactions with cytokines IL-17A, IL-17F, IL-17C, IL-17A/F heterodimer, and IL-25
IL-17RA is a protein expressed on the cell surface and is a required component of receptor complexes used by multiple IL-17 family cytokines
Blocking IL17RA inhibits IL-17 cytokine-induced responses, including the release of proinflammatory cytokines and chemokines