Secukinumab
COSENTYX
Pronunciation: sek-yoo-KIN-yoo-mab (koe-SEN-tix)
What it isMonoclonal antibody against IL-17A; plaque psoriasis, psoriatic arthritis, axial spondyloarthritis and hidradenitis suppurativa.
Why this oneIt was the first IL-17 blocker, with the broadest label in the class — spanning skin, peripheral joints and axial disease.
What limits itCandida and other infections occur; screen for tuberculosis, avoid live vaccines and avoid it when inflammatory bowel disease is active.
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Plaque psoriasis | Adults | 300 mg SC (SC at Weeks 0,1,2,3,4 then q4wk) | 300 mg q4wk (150 mg may be acceptable) | 300 mg q4wk |
| Plaque psoriasis | Pediatric ≥6 y | <50 kg: 75 mg; ≥50 kg: 150 mg (SC at Weeks 0,1,2,3,4 then q4wk) | same q4wk | 150 mg q4wk |
| Psoriatic arthritis | Adults | 150 mg SC (with loading SC at Weeks 0,1,2,3,4 then q4wk, or 150 mg q4wk without loading); IV: 6 mg/kg wk0 then 1.75 mg/kg q4wk | 150 mg q4wk; may increase to 300 mg q4wk | 300 mg q4wk SC (IV maint max 300 mg/infusion) |
| Juvenile psoriatic arthritis | Pediatric ≥2 y (≥15 kg) | ≥15 & <50 kg: 75 mg; ≥50 kg: 150 mg (SC at Weeks 0,1,2,3,4 then q4wk) | same q4wk | 150 mg q4wk |
| Ankylosing spondylitis | Adults | 150 mg SC (with or without loading); IV: 6 mg/kg wk0 then 1.75 mg/kg q4wk | 150 mg q4wk; may increase to 300 mg q4wk | 300 mg q4wk SC |
| Juvenile ankylosing spondylitis | Pediatric ≥12 y | <50 kg: 75 mg; ≥50 kg: 150 mg (SC at Weeks 0,1,2,3,4 then q4wk) | same q4wk | 150 mg q4wk |
| Non-radiographic axial spondyloarthritis | Adults | 150 mg SC (with or without loading); IV: 6 mg/kg wk0 then 1.75 mg/kg q4wk | 150 mg q4wk | 150 mg q4wk SC |
| Enthesitis-related arthritis | Pediatric ≥4 y (≥15 kg) | ≥15 & <50 kg: 75 mg; ≥50 kg: 150 mg (SC at Weeks 0,1,2,3,4 then q4wk) | same q4wk | 150 mg q4wk |
| Hidradenitis suppurativa | Adults | 300 mg SC (SC at Weeks 0,1,2,3,4 then q4wk) | 300 mg q4wk; may increase to 300 mg q2wk | 300 mg q2wk |
| Hidradenitis suppurativa | Pediatric ≥12 y (≥30 kg) | ≥30 & <90 kg: 150 mg; ≥90 kg: 300 mg (SC at Weeks 0,1,2,3,4 then q4wk) | same q4wk | 300 mg q4wk |
Renal Undefined
Hepatic Undefined
Loading: weekly at Weeks 0-4 then every 4 weeks
Instructions
- Subcutaneous injection (pen/prefilled syringe); IV formulation for adults with PsA, AS, nr-axSpA only (dilute, infuse over 30 min)
- Complete age-appropriate vaccinations before initiation; avoid live vaccines during treatment
- Evaluate for TB before initiation
- Rotate injection sites; pediatric patients should not self-administer
- Pen/prefilled syringe cap contains natural rubber latex
Available strengths
- inj 25, 150 mg/mL
Cautions
- Serious infections; caution with chronic/recurrent infection
- Hypersensitivity reactions (anaphylaxis, angioedema)
- Tuberculosis — evaluate before treatment
- Inflammatory bowel disease (new onset/exacerbation)
- Severe eczematous eruptions
- Latex hypersensitivity (pen/syringe cap)
- Avoid live vaccines
Adverse reactions
- Nasopharyngitis
- Diarrhea
- Upper respiratory tract infection
Pregnancy Limited human data insufficient; no adverse developmental effects in monkeys at up to 30x MRHD
Lactation Unknown whether excreted in human milk; consider benefits vs risk
Cost
| Strength | #/mo | generic $/unit | brand $/unit | CostPlus | |
|---|---|---|---|---|---|
| 25 mg/mL | inj | per unit | — | not offered | |
| 150 mg/mL | inj | per unit | — | $5902.41/mL | not offered |
NO BOXED WARNINGS
Principal riskInfections; new or worsening inflammatory bowel disease
Classes and tags
Clinical profile
Legacy pregnancy categoryB
Defining liabilityInfection and inflammatory-bowel-disease exacerbation