My Experience with Skyrizi

I’ve treated my psoriasis with biologics for almost two decades. My dermatologist agreed to prescribe the first biologic for psoriasis, Amevive, when it became FDA approved in 2003. It wasn’t that effective, but it introduced me to a new class of medications.

Since then I’ve tried five other biologics for my psoriasis, with Skyrizi for the last two years.

Being a candidate for Skyrizi

The Skyrizi website says that “Skyrizi is a prescription medicine use to treat adults with moderate to severe plaque psoriasis who may benefit from taking injections or pills (systemic therapy) or treatment using ultraviolet or UV light (phototherapy).”

I’ve had severe psoriasis for over forty years and continue to proactively treat it. I’m definitely a candidate for a medication like Skyrizi.

Understanding the insurance process

Since it was newly FDA approved at the time, my dermatologist, Dr. Carroll, worried that prior authorization approval for Skyrizi insurance coverage might be delayed. She suggested I try a different biologic first since my psoriasis was flaring. However, based on my discussion with my previous dermatologist I felt Skyrizi would be best to try next.

In the meantime, I went to the local clinic lab to have blood drawn for a tuberculosis (TB) test. Thankfully the TB result came back negative. Then, just over a week later, I received an email from the specialty pharmacy that my prescription request was being filled. I went online to sign up for Skyrizi Complete, a service by the manufacturer that would provide copay assistance and other resources while taking Skyrizi.

Skyrizi came much sooner than Dr. Carroll or I expected. I felt fortunate I could start taking it to see how my psoriasis might respond.

Instructions for injection

Skyrizi is taken every twelve weeks after two starter doses at week 0 and week 4. The carton comes with two syringes, which taken together makeup one dose.

The Skyrizi carton comes with injection instructions, an informational insert, two alcohol wipes to clean the injection site along with two syringes of medication. I prefer to inject in my abdomen—one syringe to the left of my belly button (at least two inches) and one to the right. Injections can be placed in the right or left thigh as well.

The instructions say to leave the carton at room temperature and out of direct sunlight for 15-30 minutes to warm. I like to inject at my desk where I have a corner to place it as it warms. The desk also has adequate lighting for my injection routine.

I took the first dose at home while on the phone with a nurse from Skyrizi Complete in case I needed any assistance.

Learning about side effects

A big question I have whenever I take a new medication is about its safety and side effects. As I mentioned before, I have been on biologics that target a particular aspect of the immune system that causes the inflammation of psoriasis for a while now. But the concerns around side effects never completely go away.

The Skyrizi website also notes that “Skyrizi may cause serious side effects, including infections. Skyrizi is a prescription medicine that may lower the ability of our immune system to fight infections and may increase your risk of infections.” Besides infections, there are a number of other listed potential side effects to taking it.

When I started taking Skyrizi I created an online journal to track my progress and side effects. I also entered calendar alerts for when I should call for a refill and take my next injection. I refer to that document before dermatology appointments or whenever I want to check for patterns of reactions and response to the medication.

With Skyrizi, I mainly get a headache with some lightheadedness post-injection. I usually feel fatigued for a day or two after as well. Once in a while, I get a mild upper respiratory infection, but not with every dose. I try to schedule a light day of work the day after injection in case I feel the effects of the medication more strongly.

Moving forward with Skyrizi

I’m familiar with self-injecting with syringes and pens after so many years of taking biologics. But when I took my first dose of Skyrizi I felt an extra sense of significance to it. I put so much hope into those first two syringes to clear my flaring psoriasis.

My psoriasis hasn’t completely cleared on Skyrizi, but it is more manageable than it was with other biologics. Since I tolerate Syrizi well overall, and I’m familiar with how to take it, I’d rather stay with Skyrizi for as long as possible. But I’ve had to adjust my dose along the way to maintain effectiveness at about the same level.

After six months on Skyrizi, I noticed my psoriasis breaking out more than before. For the next year, my dermatologist suggested I start injecting every ten weeks instead of every twelve. Since my insurance provider at the time would not cover the extra injections, my dermatologist acquired samples from the manufacturer for me to use between covered doses.

As of last month, my new insurance provider approved Dr. Carroll’s request for me to take Skyrizi every eight weeks. My skin already is doing better with the more frequent dosing. As I start my third year with Skyrizi, I hope that it will remain just as effective and safe as it has been for the last two.