Secukinumab (Cosentyx) is a human IgG1 monoclonal antibody that interferes with the binding of IL 17 to its receptors.

It is used to treat adults with the following conditions:

• Active ankylosing spondylitis in adults.
• Moderate to severe plaque psoriasis
• Active psoriatic arthritis.

Read: Ixekizumab (Taltz)

Secukinumab (Cosentyx) Dose in Adults

Secukinumab (Cosentyx) Dose in the treatment of Ankylosing spondylitis:

• 150 mg subQ at weeks 0, 1, 2, 3, and 4 followed by 150 mg every 4 weeks OR
• 150 mg subQ every 4 weeks

Secukinumab (Cosentyx) Dose in the treatment of Plaque psoriasis:

• 300 mg subQ once a week at weeks 0, 1, 2, 3, and 4 followed by 300 mg every 4 weeks.

Secukinumab (Cosentyx) Dose in the treatment of Psoriatic arthritis: 

• The regimen with a loading dose:
  • 150 mg subQ at weeks 0, 1, 2, 3, and 4 followed by 150 mg every 4 weeks.
  • The dose may be increased to 300 mg if the patients continue to have active arthritis.
• The regime without a loading dose:
  • 150 mg every 4 weeks
  • The dose may be increased to 300 mg if the patients continue to have active arthritis.
• Patients with coexistent moderate to severe plaque psoriasis:
  • 300 mg once a week at weeks 0, 1, 2, 3, and 4 followed by 300 mg every 4 weeks.

Secukinumab (Cosentyx) Dose in Children:

Efficacy and safety not established.

Pregnancy Risk Factor: B

• Studies in animals have not revealed an increase in adverse drug reactions in the fetus.
• It can also affect the effectiveness of vaccinations in children, and increase the risk of infection.

Use during breastfeeding:

• It is unknown if the drug is excreted into breastmilk or not.
• The manufacturer recommends weighing the risks and benefits of drug exposure in the child and the benefits of treating the mother before prescribing it to a nursing mother.

Dose in Renal Disease:

The manufacturer has not provided any recommendations regarding dose adjustment in patients with renal disease. It has not been studied in patients with renal disease.

Dose in Liver Disease:

The manufacturer has not provided any recommendations regarding dose adjustment in patients with liver disease. 

Side effects of Secukinumab (Cosentyx):

• Central nervous system:
  • Headache
• Dermatologic:
  • Urticaria
  • Candidiasis
• Endocrine & metabolic:
  • Hypercholesterolemia
• Gastrointestinal:
  • Diarrhea
  • Nausea
  • Mucocutaneous candidiasis
  • Inflammatory bowel disease
  • Oral herpes
• Hypersensitivity:
  • Anaphylaxis
  • Hypersensitivity
• Infection:
  • Infection
  • Serious infection
  • Herpes virus infection
  • Staphylococcal infection
• Respiratory:
  • Nasopharyngitis
  • Upper respiratory tract infection
  • Pharyngitis
  • Rhinitis
  • Rhinorrhea

Contraindications to Secukinumab (Cosentyx):

• Allergy reactions to secukinumab and any component of the formulation

Warnings and Precautions

• Hypersensitivity reactions

  • It is possible for patients to develop anaphylaxis and urticaria as a result of its use.
  • If you notice any clinical signs of severe hypersensitivity reactions, stop treatment immediately.

• Infections

  • Secukinumab can increase the risk of serious infections.
  • Clinical trials have shown that infections such as nasopharyngitis and respiratory tract infections were common.
  • Patients who have had recurrent or other chronic infections in the past should not use this drug.
  • The patient should not be treated if they have a serious infection.

• Tuberculosis

  • Before initiating treatment, all patients must be tested for tuberculosis.
  • It is not a good idea to start treatment for patients with active tuberculosis.
  • Antituberculous therapy should be considered for patients with a history of active tuberculosis. If this is not possible, a complete course of ATT should be done.
  • After treatment, patients should be closely monitored for signs and symptoms of tuberculosis.

• Inflammatory bowel disease

  • The use of secukinumab therapy for inflammatory bowel disease has been linked to flares and new onsets.
  • It is important to monitor patients for IBD symptoms.

Secukinumab: Drug Interaction

Monitoring Parameters:

Monitor for clinical features suggestive of an infection, active tuberculosis, and clinical features of inflammatory bowel diseases.

How to administer Secukinumab (Cosentyx)?

• It is administered as a subcutaneous injection.
• Before administering, allow it to reach room temperature.
• It may be administered in the lower abdomen at least 2 inches away from the navel, front of the thighs, or the outer upper arms.
• It should not be injected into a tender, bruised, indurated, red, or affected by scars or psoriasis.
• Each injection should be administered in a site different from the previously administered site.
• Following proper training, the Sensoready pen or prefilled syringe may be self-injected by the patient subcutaneously.
• The lyophilized powder form should be administered by health care providers only.
• Doses of more than 300 mg should be divided into two injections of 150 mg each.

Mechanism of action of Secukinumab (Cosentyx):

• It is a monoclonal human IgG1 antibody that inhibits interleukin 17A (IL-17A), cytokine interaction by binding to its receptors. 
• This inhibits pro-inflammatory cytokines as well as chemokines.
• Interleukin-17A, a naturally occurring cytokine, mediates immune- and inflammatory responses.

Metabolism:

• It is metabolized through the catabolic pathways that are similar to endogenous IgG.

Bioavailability and half-life:

• It has been a bioavailability of 55% to 77%, and a half-life elimination between 22 and 31 days.

The time to peak plasma concentration:

• It takes approximately 6 days after administration to reach the peak plasma concentration.

International Brand Names of Secukinumab:

• Cosentyx
• Fraizeron
• Scapho

Secukinumab Brand Names in Pakistan:

No brands available in Pakistan [/bg_collapse]