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. 2019 Apr 1;12(4):13–26.

TABLE 5.

Overview of systemic agents for the treatment of chronic plaque psoriasis, anti-IL-17 agents16,13-45,52-61

DRUG FACTORS SECUKINUMAB IXEKIZUMAB BRODALUMAB
Contraindications

  • Hypersensitivity to the agent or any component

  • Active, serious infection

  • Hypersensitivity to the agent or any component

  • Crohn’s disease

  • Use with caution in patients with recurrent infection and patients with history of depression and/or suicidal ideation/behavior
Baseline testing

  • Physical exam, history: chronic infection, IBD

  • Laboratory testing: PPD for latent TB

  • Physical exam, history: chronic infection, IBD

  • Laboratory testing: PPD for latent TB

  • Physical exam, history: chronic infection, IBD

  • Laboratory testing: PPD for latent TB
Ongoing monitoring

  • Periodic physical exam

  • Periodic physical exam; monitor for IBD,TB

  • Periodic physical exam; monitor for TB, IBD, new or worsening depression, suicidal ideation
Patient education

  • Do not receive live vaccines

  • Pregnancy Category B

  • Do not receive live vaccines

  • There are no available data on use in pregnant women to inform drug-associated risks*

  • Do not receive live vaccines

  • There are no available data on use in pregnant women to inform drug-associated risk*
Dosing schedule

  • 300mg once weekly for 4 weeks, then every 4 weeks thereafter, via subcutaneous injection

  • 80mg twice at Week 0, then biweekly for 12 weeks; every 4 weeks thereafter, via subcutaneous injection

  • 210mg once weekly for Weeks 0, 1, and 2; biweekly thereafter, via subcutaneous injection
Drug interactions

  • Live vaccines

  • Might alter or normalize metabolism of CYP450 substrates (warfarin, cyclosporine; monitor patients using these drugs for desired therapeutic effects, possible dose adjustment)

  • Live vaccines

  • Might alter or normalize metabolism of CYP450 substrates (warfarin, cyclosporine; monitor patients using these drugs for desired therapeutic effects, possible dose adjustment)

  • Live vaccines

  • Might alter or normalize metabolism of CYP450 substrates (warfarin, cyclosporine); monitor patients using these drugs for desired therapeutic effects, possible dose adjustment)
*As of June 30, 2015, the United States Food and Drug Administration no longer includes pregnancy letter categories (i.e., A, B, C, D, and X) in prescription drug labeling; prescription drugs and biologic products approved or with label updates after June 30, 2015, no longer have pregnancy letter categories.
IBD: Inflammatory bowel disease; PPD: Purified protein derivative; TB: Tuberculosis; CYP450: Cytochrome P450