Brodalumab

(Siliq®)

Siliq®

Drug updated on 5/17/2024

Dosage FormInjection (subcutaneous; 210 mg/1.5 mL)
Drug Classhuman interleukin-17 receptor A (IL-17RA) antagonist
Ongoing and
Completed Studies
ClinicalTrials.gov

Indication

  • Indicated for the treatment of moderate to severe plaque psoriasis in adult patients who are candidates for systemic therapy or phototherapy and have failed to respond or have lost response to other systemic therapies.

Summary
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  • Brodalumab (Siliq) is indicated for the treatment of moderate to severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy and have not responded or have lost response to other systemic therapies. It is highly effective in achieving Psoriasis Area and Severity Index (PASI) 90 and PASI 100 responses during short-term treatment.
  • Information on brodalumab's efficacy, safety, and comparative analysis comes from a total of 18 systematic reviews/meta-analyses.
  • Compared with other biologics such as infliximab, ixekizumab, secukinumab, guselkumab, and risankizumab, brodalumab has shown comparable or superior effectiveness in achieving high levels of skin clearance during the short-term treatment phase.
  • Studies on the safety profile indicate that the rates of serious adverse events for brodalumab do not significantly differ from those of placebos. However, caution should be exercised due to low-to-moderate quality evidence regarding these interventions' safety profiles.
  • Analysis of population considerations reveals robust evidence supporting brodalumab's efficacy among an average patient population aged around 45 years with a mean PASI score of 20; however, this may not reflect broader patient demographics seen in daily clinical practice. Subgroup analyses suggest potential differences based on prior biological therapy exposure, indicating the need for personalized treatment strategies based on individual patient history.
  • Targeted subgroup analyses focused on nail psoriasis and psoriatic arthritis show promise, suggesting potential utility beyond plaque psoriasis, which could address significant impairment areas impacting patients' quality of life.
  • Evaluation of long-term outcomes indicates that newer biologics like Siliq maintain high efficacy over time, making it a competitive option for sustained disease management given its durability, including maintenance at PASI 75/90/100 responses after one year.
  • Synthesized data, despite the lack of direct head-to-head trials for all relevant comparators, positions brodalumab among the top choices for achieving higher PASI response rates, especially considering short-term efficacy data. This emphasizes its role in treatment strategies, particularly for patients prioritizing rapid and significant skin clearance.

Product Monograph / Prescribing Information

Document TitleYearSource
Siliq (brodalumab) Prescribing Information.2020Bausch Health US, LLC., Bridgewater, NJ

Systematic Reviews / Meta-Analyses

Document TitleYearSource
Systemic pharmacological treatments for chronic plaque psoriasis: a network meta-analysis.2023The Cochrane Database of Systematic Reviews
Efficacy and safety of nail psoriasis targeted therapies: a systematic review.2023American Journal of Clinical Dermatology
Targeted therapies for patients with moderate-to-severe psoriasis: a systematic review and network meta-analysis of PASI response at 1 year. 2022Journal of Dermatological Treatment
Targeted systemic therapies for psoriatic arthritis: a systematic review and comparative synthesis of short-term articular, dermatological, enthesitis and dactylitis outcomes.2022Rheumatic & Musculoskeletal Diseases Open
Systemic pharmacological treatments for chronic plaque psoriasis: a network meta-analysis.2022The Cochrane Database of Systematic Reviews
Comparison of efficacy of anti-interleukin-17 in the treatment of psoriasis between Caucasians and Asians: a systematic review and meta-analysis.2022Frontiers in Medicine
Network meta-analysis comparing the efficacy of biologic treatments for achieving complete resolution of nail psoriasis.2021Journal of Dermatology Treatment
Short-term efficacy of biologic therapies in moderate-to-severe plaque psoriasis: a systematic literature review and an enhanced multinomial network meta-analysis.2021Dermatology and Therapy
Comparative efficacy and relative ranking of biologics and oral therapies for moderate-to-severe plaque psoriasis: a network meta-analysis.2021Dermatology and Therapy
Network meta-analysis of biologic treatments for psoriasis using absolute Psoriasis Area and Severity Index values ≤1, 2, 3 or 5 derived from a statistical conversion method.2021Journal of the European Academy of Dermatology and Venereology
Efficacy of a second interleukin 17 inhibitor in patients with psoriasis: a systematic review and meta-analysis.2021Journal of the American Academy of Dermatology
Efficacy of brodalumab for moderate to severe plaque psoriasis: a Canadian network meta-analysis. 2020Journal of Cutaneous Medicine and Surgery
Comparison of biologics and oral treatments for plaque psoriasis: a meta-analysis.2020JAMA Dermatology
Comparison of cumulative clinical benefits of biologics for the treatment of psoriasis over 16 weeks: results from a network meta-analysis.2020Journal of the American Academy of Dermatology
Short-term effectiveness of biologics in patients with moderate-to-severe plaque psoriasis: a systematic review and network meta-analysis.2020Journal of Dermatological Science
Short-term efficacy and safety of IL-17, IL-12/23, and IL-23 inhibitors brodalumab, secukinumab, ixekizumab, ustekinumab, guselkumab, tildrakizumab, and risankizumab for the treatment of moderate to severe plaque psoriasis: a systematic review and network meta-analysis of randomized controlled trials.2019Journal of Immunology Research
Long-term efficacy of novel therapies in moderate-to-severe plaque psoriasis: a systematic review and network meta-analysis of PASI response.2019Journal of the European Academy of Dermatology and Venereology
Assessing the relative efficacy of interleukin-17 and interleukin-23 targeted treatments for moderate-to-severe plaque psoriasis: a systematic review and network meta-analysis of PASI response.2019PLoS One

Clinical Practice Guidelines