What is Brodalumab: Uses, Dosage, Side Effects and More

Brodalumab is a prescription medication that helps treat moderate to severe plaque psoriasis in adults. It's a biologic drug that works by blocking specific proteins in your immune system that cause inflammation and the rapid skin cell growth seen in psoriasis.

This medication comes as a pre-filled injection that you give yourself under the skin, typically once every 12 weeks after an initial loading period. Your doctor will carefully evaluate whether brodalumab is right for you, as it requires special monitoring due to some serious but rare side effects.

What is Brodalumab?

Brodalumab belongs to a class of medications called interleukin-17 receptor antagonists. It's a targeted biologic therapy that specifically blocks the action of interleukin-17, a protein that plays a key role in causing psoriasis symptoms.

Think of interleukin-17 as a messenger that tells your immune system to create inflammation and speed up skin cell production. Brodalumab essentially interrupts this message, helping to calm down the overactive immune response that causes psoriasis plaques to form.

The medication is manufactured as a sterile solution and comes in pre-filled syringes or auto-injectors. This makes it easier for you to self-administer the injection at home once you've been properly trained by your healthcare provider.

What is Brodalumab Used For?

Brodalumab is specifically approved for treating moderate to severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy. Your doctor will typically consider this medication when topical treatments haven't provided enough relief.

Plaque psoriasis is the most common form of psoriasis, characterized by raised, red, scaly patches on the skin. These plaques can be itchy, painful, and significantly impact your quality of life. Brodalumab helps reduce the size, thickness, and redness of these plaques.

Your healthcare provider might recommend brodalumab if you have psoriasis covering a significant portion of your body, or if the condition is severely affecting your daily activities, work, or emotional well-being. The medication is reserved for cases where the benefits outweigh the potential risks.

How Does Brodalumab Work?

Brodalumab is considered a strong, targeted medication that works by blocking the interleukin-17 receptor. When this receptor is blocked, it prevents the inflammatory cascade that leads to psoriasis symptoms.

In psoriasis, your immune system mistakenly attacks healthy skin cells, causing them to multiply much faster than normal. Instead of the usual 28-day cycle, skin cells may reproduce in just 3-4 days, leading to the buildup of thick, scaly plaques.

By blocking interleukin-17 signaling, brodalumab helps slow down this accelerated skin cell production. It also reduces the inflammation that causes the redness, swelling, and discomfort associated with psoriasis plaques. Most people begin to see improvements within 4-6 weeks of starting treatment.

How Should I Take Brodalumab?

Brodalumab is given as a subcutaneous injection, which means it's injected into the fatty tissue just under your skin. Your healthcare provider will teach you how to properly prepare and administer the injection yourself.

The typical dosing schedule starts with three loading doses of 210 mg each, given at weeks 0, 1, and 2. After this initial period, you'll receive maintenance doses of 210 mg every 12 weeks. Your doctor may adjust this schedule based on your response to treatment.

You can inject brodalumab into your thigh, upper arm, or abdomen, rotating injection sites to prevent irritation. The medication should be stored in the refrigerator and brought to room temperature before injection. Never shake the medication, as this can damage the protein.

It's best to take brodalumab at the same time of day for each scheduled dose. You don't need to take it with food, but maintaining a consistent schedule helps ensure optimal effectiveness.

How Long Should I Take Brodalumab For?

The duration of brodalumab treatment varies from person to person and depends on how well you respond to the medication. Most people need to continue treatment long-term to maintain clear skin, as psoriasis is a chronic condition.

Your doctor will evaluate your progress every 3-6 months to determine if brodalumab is still the right treatment for you. If you achieve significant improvement, your healthcare provider may discuss whether to continue, adjust the dosing schedule, or consider other treatment options.

Some people may be able to extend the time between injections if their psoriasis remains well-controlled. However, stopping brodalumab entirely often leads to the return of psoriasis symptoms within a few months.

What Are the Side Effects of Brodalumab?

Like all medications, brodalumab can cause side effects, though not everyone experiences them. Understanding what to watch for helps you feel more prepared and confident about your treatment.

The most common side effects are generally mild and manageable. These include joint pain, headache, fatigue, diarrhea, throat pain, nausea, muscle pain, injection site reactions, and tinea infections (fungal skin infections like athlete's foot).

More serious but less common side effects can occur, and it's important to be aware of these possibilities:

• Increased risk of infections, including bacterial, viral, and fungal infections
• Inflammatory bowel disease, including new onset or worsening of Crohn's disease or ulcerative colitis
• Suicidal thoughts or behavior (this is rare but requires immediate medical attention)
• Allergic reactions, ranging from mild skin reactions to severe anaphylaxis

Your doctor will monitor you carefully for these potential complications. Most side effects are manageable with proper medical supervision, and the benefits of treatment often outweigh the risks for people with severe psoriasis.

Who Should Not Take Brodalumab?

Brodalumab isn't suitable for everyone, and your doctor will carefully evaluate whether it's safe for you. Certain medical conditions and situations make this medication inappropriate or require special precautions.

You should not take brodalumab if you have an active infection, including bacterial, viral, or fungal infections. The medication suppresses your immune system, which can make infections more serious or harder to treat.

People with a history of inflammatory bowel disease should use brodalumab with extreme caution, as it may worsen these conditions. Similarly, if you have a history of suicidal thoughts or depression, your doctor will need to weigh the risks and benefits very carefully.

Other considerations include recent live vaccinations, pregnancy or breastfeeding, and any known allergies to brodalumab or its ingredients. Your healthcare provider will review your complete medical history before prescribing this medication.

Brodalumab Brand Name

Brodalumab is available under the brand name Siliq in the United States. This is the only commercially available form of brodalumab currently approved by the FDA.

Siliq is manufactured by Bausch Health and comes in pre-filled syringes containing 210 mg of brodalumab in 1.5 mL of solution. The medication requires a prescription and is typically available through specialty pharmacies.

Because brodalumab is a biologic medication, there are currently no generic versions available. The patent protection and complex manufacturing process mean that Siliq remains the sole option for brodalumab therapy.

Brodalumab Alternatives

Several other biologic medications are available for treating moderate to severe psoriasis, each with its own benefits and considerations. Your doctor can help you understand which option might work best for your specific situation.

Other interleukin-17 inhibitors include secukinumab (Cosentyx) and ixekizumab (Taltz), which work similarly to brodalumab but have different dosing schedules and side effect profiles. These medications may be considered if brodalumab isn't suitable for you.

TNF inhibitors like adalimumab (Humira), etanercept (Enbrel), and infliximab (Remicade) represent another class of biologics for psoriasis. These medications work by blocking tumor necrosis factor, a different inflammatory protein involved in psoriasis.

Newer options include interleukin-23 inhibitors such as guselkumab (Tremfya), tildrakizumab (Ilumya), and risankizumab (Skyrizi). These medications often require less frequent dosing and may have different side effect patterns compared to brodalumab.

Is Brodalumab Better Than Adalimumab?

Both brodalumab and adalimumab are effective treatments for psoriasis, but they work through different mechanisms and have distinct advantages and disadvantages. The "better" choice depends on your individual circumstances, medical history, and treatment goals.

Brodalumab may offer faster initial improvement, with some people seeing results within 2-4 weeks. It's also dosed less frequently after the initial loading period, requiring injections only every 12 weeks for maintenance.

Adalimumab has been available longer and has extensive long-term safety data. It's approved for multiple conditions beyond psoriasis, including rheumatoid arthritis and inflammatory bowel disease. However, it requires more frequent injections, typically every other week.

The choice between these medications often depends on factors like your risk of infections, history of inflammatory bowel disease, injection preference, and how you've responded to previous treatments. Your dermatologist will help you weigh these factors to make the best decision for your situation.