brodalumab, Siliq

 Indications

Moderate-to-severe plaque psoriasis in patients who

are candidates for systemic therapy or phototherapy

and have failed to respond or have lost response to

other systemic therapies.

Action

A monoclonal antibody that acts as an antagonist of interleukin

(IL)–17RA by selectively binding to it and

preventing its interaction with numerous interleukin cytokines.

Antagonism prevents production of inflammatory

cytokines and chemokines. Therapeutic Effects:

Decreased plaque formation and spread.

Pharmacokinetics

Absorption: 55% absorbed following subcut administration.

Distribution: Minimally distributed to tissues.

Metabolism and Excretion: Primarily eliminated

by being catabolized into small peptides and amino acids.

Half-life: Unknown.

TIME/ACTION PROFILE (blood levels)

ROUTE ONSET PEAK DURATION

Subcut unknown 3 days unknown

Contraindications/Precautions

Contraindicated in: Crohn’s disease (may worsen

disease); Active tuberculosis.

Use Cautiously in: History of suicidality or depression;

Chronic infection or history of recurrent infection;

OB, Lactation: Safety not established; Pedi: Safety and

effectiveness not established.

Adverse Reactions/Side Effects

CNS: SUICIDAL THOUGHTS/BEHAVIORS, headache.

EENT: oropharyngeal pain. GI: Crohn’s disease, diarrhea,

nausea. Hemat: neutropenia. MS: arthralgia,

myalgia. Misc: INFECTIONS (including reactivation tuberculosis),

fatigue, injection site reactions.

Interactions

Drug-Drug: Maypantibody response to live-virus

vaccine andqrisk of adverse reactions (do not administer

concurrently). May affect activity of CYP450 enzymes

and may alter the effectiveness/toxicity of drugs

that are substrates of CYP450 (including warfarin and

cyclosporine); close monitoring is recommended and

necessary dose modifications undertaken.

Route/Dosage

Subcut (Adults): 210 mg at Wk 0, 1, and 2 then 210

mg every 2 wk; consider discontinuing therapy if adequate

response not achieved after 12–16 wk of therapy.

Availability

Solution for subcutaneous injection (prefilled

syringes): 210 mg/1.5 mL.