Pharmacy Prior Authorization Criteria

Sylvant (siltuximab)

Indications for Prior Authorization

Sylvant (siltuximab)

• For diagnosis of Multicentric Castleman's Disease
  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.

  Limitation of use: Sylvant was not studied in patients with MCD who are HIV positive or HHV-8 positive because Sylvant did not bind to virally produced IL-6 in a nonclinical study.

Criteria

Sylvant

Prior Authorization (Initial Authorization)

Length of Approval: 6 Months [A]

• Diagnosis of multicentric Castleman’s disease (MCD)
AND
• Patient is human immunodeficiency virus (HIV) negative
• Patient is human herpesvirus-8 (HHV-8) negative
AND
• Patient is human herpesvirus-8 (HHV-8) negative

Sylvant

Prior Authorization (Reauthorization)

Length of Approval: 6 Months [A]

• Patient demonstrates positive clinical response to therapy
AND
• Patient is human immunodeficiency virus (HIV) negative
AND
• Patient is human herpesvirus-8 (HHV-8) negative

P & T Revisions

2026-06-16, 2025-08-06, 2024-07-03, 2023-07-05, 2022-07-06, 2021-06-30

References

1. Sylvant Prescribing Information. Janssen Biotech, Inc. Horsham PA. June 2024.
2. Per clinical consult with hematologist/oncologist, June 5, 2014.
3. International, evidence-based consensus treatment guidelines for idiopathic multicentric Castleman disease. American Society of Hematology. Nov 2018 https://doi.org/10.1182/blood-2018-07-862334. Accessed June 2026.
4. NCCN Clinical Practice Guidelines in Oncology Castleman Disease, version 2.2026, April 2026. Accessed June 2026.

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End Notes

1. Patients should be evaluated for response to the drug every 3-6 months. A length of authorization of 6 months would be reasonable. [2]

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Revision History

• 2026-06-16: 2026 Annual Review. No criteria updates.
• 2025-08-06: 2025 Annual Review. No criteria changes. Updated references.
• 2024-07-03: 2024 Annual Review. Updated reauthorization criteria to standard reauthorization language.
• 2023-07-05: Annual review, removed specialist requirement
• 2022-07-06: Annual review, no criteria changes.
• 2021-06-30: Annual review

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