Brodalumab is a prescription medication used to address specific immune-mediated diseases. It represents a targeted approach, interacting with the body’s natural immune responses.
What is Brodalumab?
Brodalumab is a biologic medication, meaning it is derived from living organisms. It is a human monoclonal antibody, a protein engineered to target a particular substance in the body. The United States Food and Drug Administration (FDA) has approved brodalumab for the treatment of moderate to severe plaque psoriasis in adults. This medication is considered for individuals who have not responded adequately to other systemic therapies or phototherapy.
Plaque psoriasis is a chronic autoimmune condition characterized by thick, red patches of skin covered with silvery scales. Brodalumab addresses this condition by interacting with a specific pathway within the immune system.
How Brodalumab Works in the Body
Brodalumab works by selectively binding to the interleukin-17 receptor A (IL-17RA). This receptor is a protein found on the surface of various cells involved in immune responses. By binding to this receptor, brodalumab prevents several pro-inflammatory cytokines, including IL-17A, IL-17F, and the IL-17A/F heterodimer, from attaching to their receptors and initiating inflammatory signals.
Interleukin-17 (IL-17) is a family of proteins that play a significant role in promoting inflammation, particularly in autoimmune diseases like psoriasis. When brodalumab blocks the IL-17RA receptor, it inhibits the downstream signaling pathways that lead to inflammation. This blockage reduces the production of various inflammatory molecules and chemokines.
This targeted inhibition of the IL-17 pathway helps reduce the inflammation associated with plaque psoriasis. The reduction in inflammatory signals leads to the clearance of skin lesions and improvement in the overall symptoms of the condition.
Administering Brodalumab and Treatment Details
Brodalumab is administered through subcutaneous injection, meaning it is injected just under the skin. These injections can be given by a healthcare professional or, after appropriate training, by the patient themselves. The medication is available as a prefilled syringe for ease of use.
The dosage regimen for brodalumab begins with an induction phase to rapidly achieve therapeutic levels in the body. This involves a higher frequency of injections during the initial weeks of treatment. Following the induction phase, a maintenance phase begins, where injections are given less frequently to sustain the treatment effect. For example, a common initial dosing schedule might involve weekly injections for the first few weeks, followed by bi-weekly injections thereafter.
Proper storage of brodalumab is important to maintain its effectiveness. Prefilled syringes should be stored in their original container in a refrigerator, protected from light. Once a syringe has been warmed to room temperature for injection, it should not be returned to the refrigerator. A syringe can be kept at room temperature for up to 14 days.
Potential Side Effects and Safety Information
Brodalumab can cause side effects. Common side effects include injection site reactions, headache, joint pain (arthralgia), and fatigue. Other frequently observed effects can include upper respiratory tract infections, nasopharyngitis, and flu-like symptoms.
A significant safety consideration with brodalumab is a boxed warning regarding suicidal ideation and behavior. Patients with a history of depression or suicidal thoughts may have an increased risk of these events when taking brodalumab. It is important for patients and their caregivers to be aware of this risk and to seek immediate medical attention if new or worsening suicidal thoughts, depression, anxiety, or other mood changes occur. Brodalumab is available only through a restricted access program, which helps ensure patients are informed about these risks.
There is an increased risk of infections, including upper respiratory tract infections, fungal infections, and other serious infections, due to brodalumab’s impact on the immune system. Patients should be monitored for signs of infection such as fever, chills, or persistent cough. Furthermore, there is a potential for new onset or worsening of Crohn’s disease. Patients with a history of inflammatory bowel disease should discuss this with their doctor. Before starting brodalumab, it is important to discuss all medical history with a healthcare provider, including any history of mental health conditions or infections, to weigh the potential benefits against the risks.