What Is Siliq (brodalumab)?
Siliq is a prescription treatment for moderate to severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy, and whose disease has not responded to (or stopped responding to) other systemic therapies. Siliq is a biologic therapy manufactured by Valeant Pharmaceuticals, and it targets interleukin-17 receptor A (IL-17RA), a key target in the inflammatory pathway.1
What are the ingredients in Siliq?
The active ingredient in Siliq is brodalumab, which comes in an injectable form.1
How does Siliq work?
In people with plaque psoriasis, the inflammatory response of the immune system is activated and begins to damage healthy tissue. The white blood cells called T-cell lymphocytes, or T-cells, secrete cytokines that control the immune response. Some cytokines cause an increase in inflammation. The increased inflammation in people with psoriasis leads to the development of plaques on the skin.2
Interleukins (IL) are a type of cytokine, and each interleukin triggers a specific action. IL-17 stimulates the production of cytokines that increase inflammation, and Siliq blocks one key receptor (receptor A) where IL-17 normally attaches. By blocking IL-17RA, Siliq prevents the activation of this signaling pathway which is involved in increasing inflammation.1,2
What are the possible side effects of Siliq?
The most common side effects included fungal infections, nausea, low white blood cell counts, diarrhea, fatigue, muscle pain, influenza, injection site irritation, headache, throat pain, and joint pain. Since Siliq affects the body’s immune response, an increased susceptibility to infection is possible.1
Siliq has a black box warning – the strongest warning from the U.S. Food and Drug Administration (FDA) – because suicidal ideation and behavior, including completed suicides, were seen in patients taking Siliq in clinical trials. This risk was increased for individuals who had a history of depression or previous suicidal ideas and behavior.1
While there has not been a causal link established with Siliq and suicidal ideation and behavior, Siliq is only available under a controlled and restricted program called REMS (Risk Evaluation and Mitigation Strategy). The stipulations of this program include that only providers and pharmacies certified with the program can prescribe and distribute Siliq. Physicians are expected to counsel their patients on the risk of mood changes, and pharmacies are restricted from distributing Siliq to anyone not authorized to receive the drug. Further, individuals seeking Siliq are expected to sign a Patient-Prescriber Agreement Form, stating that they are aware of the risk and will seek medical attention if they experience mood changes, anxiety, depression, or suicidal thoughts or behaviors. Physicians are expected to refer individuals reporting these symptoms to a mental health professional.1 This is not an exhaustive list of side effects experienced by those taking Siliq.
Things to know about Siliq
Siliq is not intended for use by individuals with Crohn’s disease, and individuals starting Siliq should be tested for tuberculosis (TB) prior to treatment. While on Siliq, it is advised that individuals refrain from receiving any live vaccines.1
Siliq can increase the risk of developing infections, and people taking Siliq should seek medical care if they experience any signs of infection, including fever, sweats, chills, shortness of breath, muscle aches, cough, sore throat, stomach issues, frequent urination or pain while urinating, or warm or red, painful skin sores.1,2
Dosing information
Siliq is available in a single-dose, prefilled syringe. Each dose contains 210 mg of brodalumab. Injections should be administered just under the skin (subcutaneously). The first three doses are given once a week, and subsequent doses are once every two weeks.1
Siliq may be injected into the thigh, stomach area (avoiding the 2 inches surrounding the belly button), or in the upper arm if someone other than the patient is giving the injection.1,2
