Abrupt cessation of Siliq associated with rapid relapse of psoriasis

[Fred]

Following on from this thread Siliq gets FDA approval for treating psoriasis here could be another reason not to try Siliq (brodalumab)

Quote:

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Background:
Biological agents targeting IL-17 are very effective for clearing moderate to severe psoriasis. There is limited information regarding the frequency and pattern of psoriasis relapse upon treatment cessation.

Objective:
To investigate the pattern of psoriasis recurrence in patients who were treated with brodalumab following Amgen's decision to stop the clinical program in June 2015.

Materials and Methods:
Between June 2015 and March 2016, we constructed a retrospective multicenter cohort study including patients who were treated with brodalumab in Amgen's protocols after the abrupt interruption of the drug development program. The relapse was defined as the request of patient to initiate a new treatment after brodalumab withdrawal.

Results:
Seventy seven patients were followed up. At the time brodalumab treatment was stopped, 67 (87%) patients had reached PASI 90. After brodalumab discontinuation, all 77 patients relapsed after a follow up of 9 months. The median time to relapse was 46 days (range 7 to 224 days). Concerning the type of relapse, 73 patients presented with plaque psoriasis, one patient presented with erythrodermic psoriasis and 3 patients experienced pustular psoriasis. In 7 patients who had no previous history of psoriatic arthritis (PsA), the relapse of psoriasis was associated with inflammatory joint pain suggestive of PsA. At week 36, eight patients who had a limited relapse were controlled with topical treatment, 43 patients received a biological agent, two patients were included in a clinical trial with an investigational drug and 15 patients were treated with conventional systemic agents.

Conclusion:
Abrupt cessation of brodalumab is associated with a rapid relapse of psoriasis with some patients experiencing a rebound. It seems not advisable to stop treatment with IL-17 receptor antagonists abruptly even in patients who experience complete clearance of psoriasis.

Source: onlinelibrary.wiley.com

*Early view funding unknown

[jiml]

I will put that on my list of drugs not to try ....it does not read well after reading the previous post about siliq..
I hope the other drugs that target IL17 don't have the same problem of rebound if stopped abruptly  

[Fred]

I will put that on my list of drugs not to try ....it does not read well after reading the previous post about siliq..

Yep me too.

I hope the other drugs that target IL17 don't have the same problem of rebound if stopped abruptly  

I don't know of any other reports on it doing the same for Cosentyx or Taltz. But this report for Cosentyx does seem to be saying the opposite in a way:  Cosentyx gives rapid skin clearance after a pause

[mataribot]

There is a chance of rebound flare with all biologics (most are not instant). Most manufacturers request that a contaminant, such as MTX, be taken. We'll anyway, ? on this drug.

[mataribot]

Off topic - Fred, you should add the poop emoji ?

[jiml]

Off topic - Fred, you should add the poop emoji ?

[Turnedlight]

So, is that pronounced 'sill-eek' or 'silly-q' ?  

Worrying though isn't it, that this drug can bring up psa symptoms where there were none, because I have a strong suspicion that's what's happening with me and Stelara, although in my case there were symptoms of it but not in the same places and not as bad.

[jiml]

So, is that pronounced 'sill-eek' or 'silly-q' ?  

Worrying though isn't it, that this drug can bring up psa symptoms where there were none, because I have a strong suspicion that's what's happening with me and Stelara, although in my case there were symptoms of it but not in the same places and not as bad.

Yes TL it's not one for me to try .....I hope it's not what's happening to you, as they target different cells Stelara targets IL12 and 23 not IL17 like sill-eek
But worth mentioning to your dermatologist I guess

[neutral]

I have been helping my older (and much less computer literate ;-]) sister to do some research and investigating help with her fairly severe psoriasis. And I've been browsing online and across these boards over the last 4 months or so trying to learn whatever I can. Let me just say that after bouncing around from one treatment to the next over the years, her doctor has now put her on Siliq and it has done wonders for her. She told me about the black box warning. But her point of view on that was... her life has been quite miserable for the last 20+ years simply due to her constant battle with psoriasis.

She now has complete relief for the first time since she can remember. On top of that, it is SOOOOOO much more affordable than almost all of the previous options she's tried over the years. So, I'm not sure what the concerns are that were raised here. But after benefiting and learning so much from this board over the past year, I wanted to at least contribute a bit by sharing her success. I will certainly keep posted her on any changes with her treatment progress... but so far SOOOOO good.

[jiml]

I have been helping my older (and much less computer literate ;-]) sister to do some research and investigating help with her fairly severe psoriasis. And I've been browsing online and across these boards over the last 4 months or so trying to learn whatever I can. Let me just say that after bouncing around from one treatment to the next over the years, her doctor has now put her on Siliq and it has done wonders for her. She told me about the black box warning. But her point of view on that was... her life has been quite miserable for the last 20+ years simply due to her constant battle with psoriasis.

She now has complete relief for the first time since she can remember. On top of that, it is SOOOOOO much more affordable than almost all of the previous options she's tried over the years. So, I'm not sure what the concerns are that were raised here. But after benefiting and learning so much from this board over the past year, I wanted to at least contribute a bit by sharing her success. I will certainly keep posted her on any changes with her treatment progress... but so far SOOOOO good.

Hi neutral and   to the club. It's great to hear a success story for any drug, it's far better to hear personal experiences than just the information put out by the makers. I hope your sister continues with her clearance and enjoys a flake free life   I hope to read of her continued success and if you wish you could start a thread about her experience . Im sure that would help others deciding on a treatment path

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