My Experience with Skyrizi

I have treated my psoriasis with biologics for almost 2 decades. My dermatologist agreed to prescribe the first biologic for psoriasis, Amevive, when it became Food and Drug Administration (FDA)-approved in 2003. It was not that effective, but it introduced me to a new class of drugs.

Since then, I have tried 5 other biologics for my psoriasis, with Skyrizi™ for the last 2 years.

The Skyrizi website states 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 have had severe psoriasis for over 40 years and continue to proactively treat it. I am definitely a candidate for a drug like Skyrizi.

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

Understanding Skyrizi dosage and administration

Skyrizi is taken every 12 weeks after 2 starter doses at week 0 and week 4. The carton comes with 2 syringes, which taken together make up 1 dose.

The Skyrizi carton includes injection instructions, an informational insert, 2 alcohol wipes to clean the injection site, and 2 syringes of the drug. I prefer to inject in my abdomen—1 syringe to the left of my belly button (at least 2 inches) and 1 to the right. Injections can also be placed in the right or left thigh.

The instructions advise leaving the carton at room temperature and out of direct sunlight for 15 to 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 provides adequate lighting for my injection routine.

Managing side effects and tracking progress

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

A big question I have whenever I take a new drug 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 about 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.

Skyrizi has a boxed warning, the strictest warning from the US Food and Drug Administration (FDA). It has this warning because it may lower the ability of your immune system to fight infections and may increase your risk of infections.

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 drug.

With Skyrizi, I mainly get a headache with some lightheadedness post-injection. I usually feel fatigued for a day or 2 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 drug more strongly.

These are not all the possible side effects of Skyrizi. Talk to your doctor about what to expect when taking Skyrizi. You also should call your doctor if you have any changes that concern you when taking Skyrizi.

I am 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 2 syringes to clear my flaring psoriasis.

Adjusting Skyrizi treatment for continued effectiveness

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

After 6 months on Skyrizi, I noticed my psoriasis breaking out more than before. For the next year, my dermatologist suggested I start injecting every 10 weeks instead of every 12. 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.

Looking ahead with Skyrizi

As of last month, my new insurance provider approved Dr. Carroll’s request for me to take Skyrizi every 8 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 2.

Before beginning treatment for psoriasis, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.