Siliq
Siliq (brodalumab) is an under-the-skin injection that's approved for plaque psoriasis. After a couple of starter doses, you only need to inject it once every 2 weeks. Because there's a chance that Siliq (brodalumab) might raise your risk for mood problems, you must register with the Risk Evaluation and Mitigation Strategies (REMS) program for this medication. It's brand name only and can be very expensive.
What is Siliq (brodalumab)?
What is Siliq (brodalumab) used for?
Moderate to severe plaque psoriasis (where people are candidates for systemic therapy or phototherapy, but haven't responded to other treatments)
How Siliq (brodalumab) works
Siliq (brodalumab) is a monoclonal antibody that binds to receptors (proteins) in your body to lower the number of cells that cause inflammation.
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What are the side effects of Siliq (brodalumab)?
Common Side Effects
- Joint pain (5%)
- Headache (4%)
- Feeling low energy (3%)
- Diarrhea (2%)
- Sore throat (2%)
- Nausea (2%)
- Muscle pain (2%)
- Injection site reactions (2%)
Other Side Effects
- Flu like symptoms
- Low white blood cell count
- Fungal infection of the skin
Serious Side Effects
- Serious infections: fever, difficulty breathing, cough that won't go away, night sweats, confusion, feeling very tired, diarrhea, chills
- Suicidal thoughts and behaviors
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Infection—fever, chills, cough, sore throat, wounds that don't heal, pain or trouble when passing urine, general feeling of discomfort or being unwell
- Sudden or severe stomach pain, bloody diarrhea, fever, nausea, vomiting
- Thoughts of suicide or self-harm, worsening mood, feelings of depression
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
Pros and cons of Siliq (brodalumab)
Pros
May be a good option if you haven't seen results with other psoriasis medications
After the three weekly starter doses, you only need to inject it once every 2 weeks
In clinical studies, most participants saw at least half of their plaque psoriasis go away in the first month of treatment.
Cons
Must inject more often that similar alternatives for plaque psoriasis
Only available as a brand name medication so it can be very expensive
Can cause some injection site reactions
Pharmacist tips for Siliq (brodalumab)
For your first dose of Siliq (brodalumab), it's best to get it done at your healthcare provider's office so they can coach and watch to make sure you inject yourself correctly. In case you need a refresher, check out these Instructions for Use.
Inject this medication into the fatty part of the skin either on top of your thigh, belly area, or back of your upper arm if someone else is helping you with your injection. If you're injecting into the belly area, stay 2 inches away from your belly button. Don't inject into areas that are tender, red, calloused (hard), bruised, scaly, or affected by psoriasis.
Before you give yourself Siliq (brodalumab), wash your hands with soap and warm water. Also, clean the area of skin where you're going to inject the medication with an alcohol wipe. Don't touch the area once you've cleaned it. Just allow it to air dry.
The liquid in the prefilled syringe should be either clear or have a slightly yellow color, and it shouldn't really have any particles (solid chunks) floating around in it. If you see cloudy or discolored liquid with large particles, don't give yourself the injection. Instead, call your provider or pharmacist to see if it's possible to get a replacement.
Make sure to inject yourself with the full amount of medication (about 1.5 mL). This amount will provide you with the dose of 210 mg that's needed each time.
It's possible that Siliq (brodalumab) might trigger thoughts of suicide or self-harm. If you experience suicidal thoughts or unusual behavior (e.g., anxiety, panic attacks, difficulty sleeping, feeling angry or irritated, restlessness) while taking Siliq (brodalumab), call your provider right away.
Frequently asked questions about Siliq (brodalumab)
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What are the risks and warnings for Siliq (brodalumab)?
Siliq (brodalumab) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Suicidal thoughts and behavior
Risk factors: History of suicidal thoughts or behaviors
Although rare, a few people who took Siliq (brodalumab) have commited suicide. But there's no clear evidence that shows this medication caused the suicides. To be cautious, people who've a history of depression or suicidal thoughts should only take Siliq (brodalumab) if their provider think the benefit is greater than the risk. If you experience suicidal thoughts or unusual behavior (e.g., anxiety, panic attacks, difficulty sleeping, feeling angry or irritated, restlessness) while taking Siliq (brodalumab), call your provider right away.
Because of this risk, Siliq (brodalumab) is only available through a restricted program under Risk Evaluation and Mitigation Strategies (REMS) called the SILIQ REMS Program. Your provider, pharmacy, and you must all be registered with this program in order to prescribe, dispense, or take this medication. This program will help your provider monitor you for mood changes, new or worsening anxiety or depression, or abnormal thoughts.
Serious infections
Risk factors: Active, long-term, or frequent infection | Conditions that can raise your risk for infection
Siliq (brodalumab) can raise your risk of serious or life-threatening infections. Serious infections are more likely to happen if you have other long-term conditions. If you develop any symptoms of an infection, such as fever, difficulty breathing, a cough that won't go away, night sweats, or confusion, contact your provider right away. Don't take Siliq (brodalumab) if you have an active infection.
Make sure your provider knows your medical history before starting Siliq (brodalumab), especially if you've ever had tuberculosis (TB). This medication can cause new or old TB infections to come back. For this reason, you'll need to get tested for TB before starting Siliq (brodalumab) and during treatment. If you test positive (meaning that you’re infected), you’ll likely have to get treated for TB before starting or continuing Siliq (brodalumab).
To help avoid getting sick, your provider will make sure that you're all up-to-date with your vaccines before you start Siliq (brodalumab). Once you start treatment with this medication, you won't be able to get live vaccines, like the measles, mumps, and rubella vaccine (MMR), FluMist (nasal flu vaccine), or Varivax (varicella vaccine). This is because there's a chance that you might get sick from the live vaccines since Siliq (brodalumab) cause your immune system to not work as well.
Crohn's disease
Risk factors: Crohn's disease
People with Crohn's disease shouldn't take Siliq (brodalumab) because it could make symptoms worse. This medication can even cause Crohn's disease to develop if you've never had it before. If you experience unexplained diarrhea, fever, stomach pain, weight loss, and a loss of energy, call your provider because you may need to stop taking this medication.
Siliq (brodalumab) dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 2 syringes of 210mg/1.5ml | 1 carton | $3775.34 | $3775.34 |
Typical dosing for Siliq (brodalumab)
The typical dose of Siliq (brodalumab) starts out with three starter doses at weeks 0, 1, and 2, and then you'll take it every 2 weeks. Siliq (brodalumab) comes in a single-dose prefilled syringe that contains 210 mg (1.5 mL) of medication.
Week 0 (beginning of treatment): Inject 210 mg under the skin once
Week 1: Inject 210 mg under the skin once
Week 2: Inject 210 mg under the skin once
Week 4 and on: Inject 210 mg under the skin once every 2 weeks
How much does Siliq (brodalumab) cost?
Siliq (brodalumab) contraindications
Crohn's disease
What are alternatives to Siliq (brodalumab)?
Moderate to severe plaque psoriasis (where people are candidates for systemic therapy or phototherapy, but haven't responded to other treatments)
Moderate-to-severe plaque psoriasis (Ps) - adults and children 6 years and older
Psoriatic arthritis (PsA) - adults and children 6 years and older
Moderate-to-severe Crohn's disease (CD)
Moderate-to-severe ulcerative colitis (UC)
Moderate-to-severe plaque psoriasis
Active psoriatic arthritis
Moderate-to-severe ulcerative colitis (UC)
Moderate-to-severe Crohn's disease (CD)
What is the latest news about Siliq (brodalumab)?
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