brodalumab: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
brodalumab: clinical details
Prescribing considerations
- Use under a physician experienced in diagnosing and treating psoriasis.
- Assess for current, chronic or recurrent infection and tuberculosis before starting; treat latent tuberculosis where appropriate.
- Review inflammatory bowel disease history and current gastrointestinal symptoms.
- Assess depression, anxiety, previous suicidal ideation or behaviour and emerging mood changes.
- Complete appropriate immunisations before treatment where possible; avoid concurrent live vaccines.
- Combination with other immunosuppressants, biologics or phototherapy has not been evaluated.
Contraindications and cautions
- Hypersensitivity to brodalumab or an excipient
- Active Crohn's disease
- Clinically important active infection, including active tuberculosis
Monitoring
- Record the product name and batch number for traceability.
- Monitor clinical response and reassess continued treatment if response is inadequate.
- Monitor for infection, inflammatory bowel symptoms, serious hypersensitivity and new or worsening mood symptoms.
- Withhold administration during a serious infection until it resolves.
- No specific routine laboratory-monitoring programme is stated in the product information; neutropenia is an uncommon adverse effect.
Clinical pharmacology
A fully human IgG2 monoclonal antibody against IL-17 receptor A. It blocks signalling from several IL-17 cytokines and has non-linear, target-mediated pharmacokinetics; elimination is expected mainly through protein catabolism.
Formulation and product differences
- The product is a clear to slightly opalescent, colourless to slightly yellow solution in a single-use pre-filled syringe for subcutaneous injection.
- It contains proline, glutamate, polysorbate 20 and water for injections.
- It may be kept once at room temperature, protected from light, for up to 14 days; after reaching room temperature it should not be returned to the refrigerator.
brodalumab preparations and strengths
Injection
Route: Parenteral
Strengths: 210 mg
brodalumab interactions
Tell the prescribing team about medicines, vaccines and other psoriasis treatments. Important considerations include:
Live vaccines
Do not give concurrently because safety and vaccine-related infection risk have not been established.
Other biologics or systemic immunosuppressants
Combined safety and effectiveness have not been evaluated, so specialist review is required.
Phototherapy
Combined use has not been evaluated and should be reviewed by the treating dermatologist.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.