An Overview of Cosentyx

FDA-Approved for Certain Spondyloarthropathies and Psoriatic Arthritis

Young man is giving himself injection in the abdomen.
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Cosentyx (secukinumab), manufactured by Novartis, was approved by the FDA on January 15, 2016 for the treatment of adults with active ankylosing spondylitis and active psoriatic arthritis. It had already been approved in January 2015 for moderate to severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy. Ankylosing spondylitis and psoriatic arthritis are inflammatory types of arthritis which are classified as spondyloarthropathies.

The approval of Cosentyx for ankylosing spondylitis and psoriatic arthritis was based on results from two ankylosing spondylitis and two psoriatic arthritis placebo-controlled phase III clinical trials which evaluated safety and effectiveness. The trials involved more than 1,500 adults who had one of the two conditions. It is the first drug in its class that has been approved to treat these conditions.

What Is Cosentyx?

Cosentyx is a medication that works on the immune system to treat these diseases.

IL-17A is a signaling molecule that can be produced by certain cells in your immune system. It can also affect the functioning of various types of cells, including other immune cells, bone cells, cartilage cells, cells lining blood vessels.

On the whole, when IL-17A binds to cells, it triggers inflammatory effects, such as the activation of immune cells, thus promoting some of the changes that lead to the symptoms of ankylosing spondylitis and psoriatic arthritis.

Cosentyx works to block the changes and inflammatory effects that lead to AS and psoriatic arthritis symptoms.

Specifically, it binds to IL-17A already present in your blood and makes it unable to trigger its response in other cells.

You can imagine that the IL-17A is like a key which opens the receptors on cells, causing later inflammatory effects. Cosentyx is a monoclonal antibody that binds the key and makes it unable to “open” the receptors on nearby cells. However, the immune system is otherwise able to work normally. 

How Is the Drug Administered?

Cosentyx is administered by subcutaneous injection in the upper thighs or the abdomen. You will need to receive training from your doctor or another health professional before you can administer the medication yourself. You shouldn't try to do this yourself until you've received the proper instructions. However, it isn't hard to do once you know how!

Pen vs. Syringe

Cosentyx is available as an injectable solution (150 mg/mL) in a single-use Sensoready pen. The medication needs to be stored in the refrigerator before administration and should be removed from the refrigerator about 15 minutes before. Do not shake or reuse a pen.

You'll pick a spot on your thighs or lower abdomen, using a slightly different location each time. Avoid any spot that is tender, bruised, or scarred. After cleaning the area, you will use the pen to inject the medication. If you have trouble with needles, you may have someone else in your family give you the drug (if they have been trained).

Depending on the dose you've been prescribed, you may need to take one or more injections.

Cosentyx is also available in a single-use prefilled syringe (150 mg/mL). The administration is very similar, but you will use a syringe instead of a pen.

Post-Injection Bleeding

There may be a small amount of blood at the injection site afterward. This is normal and not a cause for concern. If it happens, you can apply a cotton ball for a few seconds and a bandage if needed.

Disposal

The pen or syringe will need to be disposed of in a proper sharps disposal container approved by the FDA.

Dosage

For people with active psoriatic arthritis or ankylosing spondylitis, the standard recommended dose of Cosentyx involves a loading dose of 150 mg at weeks zero, one, two, three, and four. After that, it can be given every four weeks. If the disease remains active, a dose of 300 mg can be considered.

For plaque psoriasis, the recommended dose is 300 mg at weeks zero, one, two, three, and four and every four weeks thereafter. A lower dose of 150 mg may be enough for some people.

For people with both psoriatic arthritis and plaque psoriasis, the protocol for plaque psoriasis is recommended. Your doctor will work with you to find the right dose for you.

Side Effects

The most common side effects associated with Cosentyx include nasopharyngitis (cold symptoms), upper respiratory infections, and diarrhea. Other possible side effects include a headache and nausea.

Usually, these symptoms are not severe and are often temporary. If necessary, they can be treated with standard over-the-counter products.

Other side effects are possible. If you experience anything of concern, contact your doctor. 

If you experience trouble breathing after taking Cosentyx, you may be having an anaphylactic reaction. Call 911 for immediate medical attention.

Who Should Not Take Cosentyx?

People who have had a severe allergic reaction to secukinumab should not use the medication. People with active tuberculosis infections should also not use Cosentyx. In these cases, other medications may provide better options.

As a precaution, prior to starting treatment with Cosentyx, you should be checked for tuberculosis. If your doctor feels you are at risk for tuberculosis because you have been exposed, you may be treated for TB before starting Cosentyx. 

In general, it's a good idea to get up-to-date on your vaccinations before you begin the drug. That's because live vaccines should not be given to you while taking Cosentyx, because of the way the drug works with the immune system.

Warnings and Precautions

Cosentyx is not for everyone. In some scenarios, your doctor may decide that you are not a good candidate and offer other treatments instead.

Lowered Immune System

Because Cosentyx acts on the immune system, it may lower your ability to fight infections and may increase your risk of infections. If a serious infection develops while you are using Cosentyx, discontinue the medication while the infection is treated under the guidance of your physician.

If you have a current infection, chronic infection, or history of recurrent infections, you should exercise caution and discuss your infection history with a doctor prior to using Cosentyx. 

Inflammatory Bowel Disease

In clinical trials, new onset cases of inflammatory bowel disease were noted, as well as exacerbations in those with IBD. Caution should be used when Cosentyx is prescribed to someone with known IBD. You may want to talk to your doctor about whether another drug, such as a TNF-inhibitor, might be a better option.

Pregnancy and Nursing

There have been no adequate studies of Cosentyx in pregnant or nursing women. It is also unknown whether Cosentyx is excreted in human milk or absorbed systemically after ingested. Talk with your doctor about whether another treatment option makes sense for you.

A Word From Verywell

As we know, drugs are not equally effective for all people who try them, and different people have different medical risks. That's why it is important to have several treatment options.

Cosentyx is the first drug to target interleukin-17A, a treatment pathway which was not available before the drug's approval. If you're interested in learning more about this option, bring it up to your healthcare professional. He or she will help you make the best decision for you.

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