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Psoriasis Club › HealthHealth Boards › Psoriasis In The News v
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Siliq gets FDA approval for treating psoriasis

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Siliq gets FDA approval for treating psoriasis
Fred Offline
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#1
News  Thu-16-02-2017, 13:10 PM
Following on from this post Brodalumab could be approved for psoriasis soon the FDA have now given approval for the use of Siliq (brodalumab) for the treatment of adults with moderate-to-severe plaque psoriasis.

Quote:
Siliq is administered as an injection.

Siliq is intended for patients who are candidates for systemic therapy (treatment using substances that travel through the bloodstream, after being taken by mouth or injected) or phototherapy (ultraviolet light treatment) and have failed to respond, or have stopped responding to other systemic therapies.

"Moderate-to-severe plaque psoriasis can cause significant skin irritation and discomfort for patients, and today’s approval provides patients with another treatment option for their psoriasis," said Julie Beitz, M.D., director of the Office of Drug Evaluation III in the FDA’s Center for Drug Evaluation and Research. "Patients and their health care providers should discuss the benefits and risks of Siliq before considering treatment."

Psoriasis is a skin condition that causes patches of skin redness and flaking. Psoriasis is an autoimmune disorder that occurs more commonly in patients with a family history of the disease, and most often begins in people between the ages of 15 and 35. The most common form of psoriasis is plaque psoriasis, in which patients develop thick, red skin with flaky, silver-white scales.

Siliq’s active ingredient (brodalumab) binds to a protein that causes inflammation, inhibiting the inflammatory response that plays a role in the development of plaque psoriasis.

Siliq’s safety and efficacy were established in three randomized, placebo-controlled clinical trials with a total of 4,373 adult participants with moderate-to-severe plaque psoriasis who were candidates for systemic therapy or phototherapy. More patients treated with Siliq compared to placebo had skin that was clear or almost clear, as assessed by scoring of the extent, nature and severity of psoriatic changes of the skin.

Suicidal ideation and behavior, including completed suicides, have occurred in patients treated with Siliq during clinical trials. Siliq users with a history of suicidality or depression had an increased incidence of suicidal ideation and behavior compared to users without this history. A causal association between treatment with Siliq and increased risk of suicidal ideation and behavior has not been established.

Because of the observed risk of suicidal ideation and behavior, the labeling for Siliq includes a Boxed Warning and the drug is only available through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS) called the Siliq REMS Program. Notable requirements of the Siliq REMS Program include the following:

Prescribers must be certified with the program and counsel patients about this risk. Patients with new or worsening symptoms of depression or suicidality should be referred to a mental health professional, as appropriate.
   
Patients must sign a Patient-Prescriber Agreement Form and be made aware of the need to seek medical attention should they experience new or worsening suicidal thoughts or behavior, feelings of depression, anxiety or other mood changes.
   
Pharmacies must be certified with the program and must only dispense to patients who are authorized to receive Siliq.

Siliq is also approved with a Medication Guide to inform patients of the risk of suicidal ideation and behavior, and that because Siliq is a medication that affects the immune system, patients may have a greater risk of getting an infection, or an allergic or autoimmune condition. Patients with Crohn’s disease should not use Siliq. Health care providers should also evaluate patients for tuberculosis (TB) infection prior to initiating treatment with Siliq. Health care providers should not administer Siliq to patients with active TB infection, and should avoid immunizations with live vaccines in patients being treated with Siliq.

The most common adverse reactions reported with the use of Siliq include joint pain (arthralgia), headache, fatigue, diarrhea, throat pain (oropharyngeal pain), nausea, muscle pain (myalgia), injection site reactions, influenza, low white blood cell count (neutropenia) and fungal (tinea) infections.

Source: fda.gov
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D Foster Online
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#2
Thu-16-02-2017, 13:43 PM
That sounds like a bundle of fun to use. !!! Rolaf
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mataribot Offline
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#3
Thu-16-02-2017, 16:17 PM
Just FYI. According to my old dermatologist, one of the completed suicides was in the placebo group. The drug manufacturer themselves, aren't sure if the drug itself cause these problems.
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Fred Offline Author
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#4
Thu-16-02-2017, 16:29 PM
(Thu-16-02-2017, 16:17 PM)mataribot Wrote: Just FYI. According to my old dermatologist, one of the completed suicides was in the placebo group. The drug manufacturer themselves, aren't sure if the drug itself cause these problems.

I'm not sure how they say they are not sure when there were six in total, so allowing for the 1 placebo that's still 5 from their trials. Confused

Quote:
In clinical trials of the drug, brodalumab, there were six suicides across all programs: four in psoriasis studies, one in a rheumatoid arthritis study and one in a psoriatic arthritis study.

Maybe it's worth a go for some people, but there are plenty of other treatments today that don't have the same label. So I think it may struggle to get patient backing myself, but we'll see.
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jiml Offline
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#5
Thu-16-02-2017, 18:07 PM
To try that I would have to be desperate for relief, even then I think I would rather have the disease... the side effects are just to scary to contemplate for myself .
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Fred Offline Author
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#6
Thu-16-02-2017, 19:40 PM
(Thu-16-02-2017, 18:07 PM)jiml Wrote: To try that I would have to be desperate for relief, even then I think I would  rather have the disease... the side effects are just to scary to contemplate for myself .

I think if options were short it could be worth a try, but Cosentyx and Taltz are much the same thing and are proving to be very effective. So I think a lot of patients will feel the same as you.
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jiml Offline
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#7
Thu-16-02-2017, 20:39 PM
(Thu-16-02-2017, 19:40 PM)Fred Wrote:
(Thu-16-02-2017, 18:07 PM)jiml Wrote: To try that I would have to be desperate for relief, even then I think I would  rather have the disease... the side effects are just to scary to contemplate for myself .

I think if options were short it could be worth a try, but Cosentyx and Taltz are much the same thing and are proving to be very effective. So I think a lot of patients will feel the same as you.

I think there are too many other options to consider to even contemplate Siliq for me ....it even makes methotrexate look attractive to me Confused
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D Foster Online
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#8
Thu-16-02-2017, 22:48 PM
I wonder if they countered the ones that committed suiside as cured of the P.
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mataribot Offline
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#9
Fri-17-02-2017, 00:50 AM
I wouldn't try it for same reason as everyone else, but I am thinking they need more data. They may have not screened properly for mental heal prior to the trials, or it may simply be the drug. There are lot of new treatments that will be available- this one probably last in line.
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Caroline Offline
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#10
Fri-17-02-2017, 09:45 AM
(Fri-17-02-2017, 00:50 AM)mataribot Wrote: I wouldn't try it for same reason as everyone else,  but I am thinking they need more data. They may have not screened properly for mental heal prior to the trials, or it may simply be the drug. There are lot of new treatments that will be available- this one probably last in line.

Yes, I agree I think you should investigate that.
Also, you should put "average" suicidal rates next to it in order to neatly compare it.

The other side effects though, do not seem so well for me. Of course you don't have to get them all, but.... the stuff seems to quite weaken your immune system.
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