Using Cosentyx to Treat Psoriatic Arthritis and Ankylosing Spondylitis

FDA-Approved for Certain Spondyloarthropathies and Plaque Psoriasis

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. 

What Is Cosentyx?

Cosentyx is a medication that works on the immune system to treat the aforementioned diseases and conditions. Specifically, Cosentyx is a human interleukin-17A antagonist (IL-17A)—a monoclonal antibody that binds to IL-17A and blocks interaction with the IL-17 receptor. It is the first interleukin-17A antagonist approved to treat ankylosing spondylitis, psoriatic arthritis, and plaque psoriasis. 

How Is the Drug Administered?

Cosentyx is administered by subcutaneous injection in the upper thighs or the abdomen. Cosentyx is available as an injectable solution (150 mg/mL) in a single-use Sensoready pen. It is also available in a single-use prefilled syringe (150 mg/mL). There is a vial which must be reconstituted, too, but that is for healthcare professionals only.

For people with active psoriatic arthritis or ankylosing spondylitis, the recommended dose of Cosentyx involves a loading dose of 150 mg at weeks 0, 1, 2, 3 and 4, followed by every 4 weeks. It can also be given every 4 weeks without the loading dose. If the disease remains active, a dose of 300 mg can be considered. For plaque psoriasis, the recommended dose is 300 mg at weeks 0, 1, 2, 3, 4 and every 4 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.    

Who Should Not Use Cosentyx?

People who have had a severe allergic reaction to secukinumab should not use the medication.

Common Side Effects

The most common side effects associated with Cosentyx include nasopharyngitis (cold symptoms), upper respiratory infections, and diarrhea. Other side effects are possible and if you experience anything of concern, contact your doctor. 

Warnings and Precautions

Certain warnings and precautions are associated with Cosentyx:

  • Serious infections have occurred with its use. Because Cosentyx acts on the immune system, it may lower your ability to fight infections and it may increase your risk of infections. If a serious infection develops while you are using Cosentyx, discontinue the medication while the infection is treated. In fact, people with a current infection, chronic infection, or history of recurrent infections should exercise caution and discuss their infection history with their doctor prior to using Cosentyx. 
  • 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 and while you are treated with Cosentyx. 
  • 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.
  • Anaphylactic or serious allergic reactions are possible. If it occurs, Cosentyx should be discontinued immediately and you should seek medical help.
  • Live vaccines should not be given to you, if you use Cosentyx.
  • There have been no adequate studies of Cosentyx in pregnant women. It is also unknown whether Cosentyx is excreted in human milk or absorbed systemically after ingested. Caution should be used.

A Word From Verywell

As we know, drugs are not equally effective for all people who try them. That's why it is important to have several treatment options. Since Cosentyx is the first drug to target interleukin-17A, a treatment pathway is available now which was not available before the drug's approval.

To use Cosentyx safely, you must learn how to properly inject, be aware of potential side effects and warnings, and report any adverse events if they occur. If you're interested in learning more about this option, bring it up to your healthcare professional. He or she will walk you through to the best decision for you.

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