SYLVANT results
The effectiveness of SYLVANT® (siltuximab) has been proven in the only randomized clinical trial in patients with idiopathic multicentric Castleman disease (iMCD). The primary treatment goals of the trial were reduction in lymph node size and improvement in symptoms. According to the trial criteria, these improvements must last for at least 18 weeks without treatment failure.
Low
None of the patients on placebo achieved the primary or the secondary treatment goals.
The SYLVANT clinical trial referenced above took place before the diagnostic guidelines for iMCD were available.
Application of diagnostic guidelines showed a greater response to SYLVANT
The diagnostic guidelines for iMCD consist of several criteria that are used by doctors to diagnose patients faster. The minor diagnostic criteria include symptoms such as enlarged liver, enlarged spleen, fever, fatigue, and fluid accumulation.
In the clinical trial, SYLVANT was studied for 48 weeks after the last patient began treatment, which was approximately 3 years of follow-up. Once the guidelines were applied to the data from the clinical trial (mentioned above), it was found that there was significant improvement when ≥2 minor criteria were met.
Significant Improvement When at Least 2 Minor Criteria Are Met
The NCCN recommends siltuximab (SYLVANT) as the preferred primary treatment for iMCD
The CDCN also recommends the frontline use of SYLVANT in treating iMCD
Using Fisher’s exact test, patients who met at least 2 minor criteria
were significantly more likely to respond to SYLVANT than those who did
not
After starting SYLVANT, patients may start to see some symptom improvement within the first few weeks, but it may take between 4 and 9 months for lymph nodes to shrink. That’s why it is important for patients to stay on SYLVANT.
After I started treatment with SYLVANT, my symptoms started to decrease. I was getting my appetite back and the night sweats decreased.
– Carl, iMCD patient
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