Drug updated on 4/17/2024
| Dosage Form | Injection (intravenous; 100 mg, 400 mg) |
| Drug Class | Interleukin-6 antagonists |
| Ongoing and Completed Studies | ClinicalTrials.gov |
Indication
- Indicated for the treatment of patients with multicentric Castleman’s disease (MCD) who are human immunodeficiency virus (HIV) negative and human herpesvirus-8 (HHV-8) negative.
Summary
- Siltuximab (Sylvant) is indicated for the treatment of patients with multicentric Castleman’s disease (MCD) who are human immunodeficiency virus (HIV) negative and human herpesvirus-8 (HHV-8) negative. This drug has demonstrated efficacy and long-term safety but with a response rate of less than 50%, which suggests reduced effectiveness in certain patients compared to alternative treatments such as thalidomide and tocilizumab.
- The insights into the effectiveness and safety profiles of siltuximab against other drugs were gained from four systematic reviews/meta-analyses.
- Compared to other IL-6 inhibitors like tocilizumab, siltuximab shows utility beyond Castleman's disease in treating various inflammatory diseases. Its safety profile is comparable, suggesting it is as tolerable as these alternatives.
- There is potential for using siltuximab in treating severe COVID cases due to an increase in cytokines; however, this evidence is derived from limited clinical experiences, highlighting the need for more conclusive trials.
- Specifically focusing on the HIV-negative and HHV-negative populations suffering from MCD, there are broader implications for its use across a spectrum of immune-mediated conditions including severe COVID cases and multiple myeloma, which support personalized treatment approaches based on individual patient profiles and disease phenotypes.
- The optimal use of Sylvant depends on patient-specific factors and disease characteristics given varying degrees of efficacy depending on the condition being treated. Further researches, along with clinical trial outcomes, will better delineate its positioning among therapeutic options where both efficacy and safety profiles need consideration.
Product Monograph / Prescribing Information
| Document Title | Year | Source |
|---|---|---|
| Sylvant (siltuximab) prescribing information. | 2019 | FDA |
Systematic Reviews / Meta-Analyses
| Document Title | Year | Source |
|---|---|---|
| Efficacy and safety of regimens used for the treatment of multicentric Castleman disease: A systematic review. | 2022 | European Journal of Haematology |
| A systematic literature review informing the consensus statement on efficacy and safety of pharmacological treatment with interleukin-6 pathway inhibition with biological DMARDs in immune-mediated inflammatory diseases. | 2022 | Rheumatic & Musculoskeletal Diseases Open |