The correct answer is D. Brodalumab is a monoclonal IgG antibody directed at the IL-17 receptor and is approved for moderate to severe plaque psoriasis. 4 cases of suicide were documented during clinical trials, resulting in the FDA warning, although it should be noted that unlike in the clinical trials for other recently approved biologics, there was not a specific exclusion of subjects with a history of psychiatric events or prior suicide attempts. There is mixed evidence as to whether psoriasis itself may increase the risk of suicidal ideation and attempts (one positive and one negative meta-analysis—Singh and Chi respectively). There are no such black box warnings for methotrexate, tazarotene (a topical retinoid), and betamethasone dipropionate (a topical steroid).
Publication reference : Rodriguez-Bolanos F, Gooderham M, Papp K. A Closer Look at the Data Regarding Suicidal Ideation and Behavior in Psoriasis Patients: The Case of Brodalumab. Skin Therapy Lett 2019; 24: 1-4
Reference URL: https://www.skintherapyletter.com/psoriasis/suicidal-behavior-psoriasis-brodalumab/
Publication reference : Singh S, Taylor C, Kornmehl H, et al. Psoriasis and suicidality: a systematic review and meta-analysis. J Am Acad Dermatol. 2017 Sep;77(3):425-40 e2.
Reference URL: https://pubmed.ncbi.nlm.nih.gov/28807109/
Publication reference : Chi CC, Chen TH, Wang SH, et al. Risk of suicidality in people with psoriasis: a systematic review and meta-analysis of cohort studies. Am J Clin Dermatol. 2017 Oct;18(5):621-7.
Reference URL: https://pubmed.ncbi.nlm.nih.gov/28409490/