Secukinumab is a human monoclonal antibody designed for the treatments of uveitis, rheumatoid arthritis, and psoriasis.
It targets member A from the cytokine family of interleukin 17.
Secukinumab (brand name Cosentyx) is a biologic medication used to treat several chronic inflammatory conditions by targeting the immune system.
It is a fully human monoclonal antibody that specifically blocks interleukin-17A (IL-17A), a protein (cytokine) that drives inflammation in the body.
Interleukin‑17A, a key cytokine driving keratinocyte activation and joint/entheseal inflammation.
By neutralizing IL‑17A, it reduces downstream inflammatory signaling.
Secukinumab is approved for the treatment of: Plaque Psoriasis: Moderate to severe cases in adults and children (6 years and older). Psoriatic Arthritis (PsA): Active disease in adults and children (2 years and older). Ankylosing Spondylitis (AS): Active disease in adults. Non-radiographic Axial Spondyloarthritis (nr-axSpA): In adults with objective signs of inflammation. Hidradenitis Suppurativa (HS): Moderate to severe cases in adults. Enthesitis-Related Arthritis (ERA): In pediatric patients (4 years and older). Juvenile psoriatic arthritis.
Treatment typically begins with a loading phase of weekly injections for the first five weeks, followed by monthly maintenance doses.
Given as a subcutaneous injection, typically with a loading phase weekly for 5 weeks followed by maintenance every 4 weeks in most indications; HS maintenance can be every 2 or 4 weeks depending on regimen.
Adult doses are usually 150–300 mg depending on indication and severity; pediatric dosing is weight‑based and indication‑specific.
Subcutaneous Injection: Most patients self-administer the drug at home using a prefilled syringe or an autoinjector pen (Sensoready or UnoReady).
Intravenous (IV) Infusion: For certain conditions like PsA and AS, it can be administered intravenously.
Because secukinumab affects the immune system, and carries several risks:
Infections: It can lower the body’s ability to fight infections.
Patients should be tested for tuberculosis (TB) before starting treatment.
Inflammatory Bowel Disease (IBD): It may cause new or worsening symptoms of IBD (such as Crohn’s disease or ulcerative colitis).
Vaccinations: Patients should avoid live vaccines while taking secukinumab.
Efficacy: Plaque psoriasis: in adult RCTs, ~79% achieved PASI 75 at 12 weeks vs 44% with etanercept and 4% with placebo; ~65% achieved clear/almost clear skin vs 27% etanercept and 2% placebo.
Pediatric psoriasis: ~80% achieved PASI 75 and ~70% clear/almost clear skin at 12 weeks vs 66% and 36% with etanercept and 15% and 6% with placebo.
Psoriatic arthritis: ~51–54% achieved ACR20 at 24 weeks vs 15% with placebo.
Ankylosing spondylitis: 61% achieved ASAS20 at 16 weeks vs 28% with placebo; in nr‑axSpA, 41% achieved ASAS40 vs 29% placebo.
Hidradenitis suppurativa: about 44% achieved ≥50% reduction in abscesses/nodules at 16 weeks without worsening in abscesses/fistulas vs 32% with placebo.
Common Side Effects: These include cold symptoms (upper respiratory tract infections), diarrhea, headaches, skin rashes, nasopharyngitis and mild mucocutaneous Candida infections;
Warnings include: risk of serious infections, potential exacerbation/new onset inflammatory bowel disease, and need for TB evaluation before initiation; live vaccines should be avoided during therapy.