Note: Evaluate patients for tuberculosis (TB) infection prior to initiating treatment with secukinumab.
Ankylosing spondylitis: SUBQ:
With a loading dose: 150 mg at weeks 0, 1, 2, 3, and 4 followed by 150 mg every 4 weeks; consider an increase to 300 mg every 4 weeks in patients who continue to have active ankylosing spondylitis.
Without a loading dose: 150 mg every 4 weeks; consider an increase to 300 mg every 4 weeks in patients who continue to have active ankylosing spondylitis.
Axial spondyloarthritis (nonradiographic): SUBQ:
With a loading dose: 150 mg at weeks 0, 1, 2, 3, and 4 followed by 150 mg every 4 weeks.
Without a loading dose: 150 mg every 4 weeks.
Plaque psoriasis: SUBQ: 300 mg once weekly at weeks 0, 1, 2, 3, and 4 followed by 300 mg every 4 weeks. Some patients may only require 150 mg per dose.
Psoriatic arthritis: SUBQ:
With a loading dose: 150 mg at weeks 0, 1, 2, 3, and 4 followed by 150 mg every 4 weeks; consider an increase to 300 mg every 4 weeks in patients who continue to have active psoriatic arthritis.
Without a loading dose: 150 mg every 4 weeks; consider an increase to 300 mg every 4 weeks in patients who continue to have active psoriatic arthritis.
Coexistent moderate to severe plaque psoriasis: 300 mg once weekly at weeks 0, 1, 2, 3, and 4 followed by 300 mg every 4 weeks. Some patients may only require 150 mg per dose.
Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.
There are no dosage adjustments provided in the manufacturer's labeling (has not been studied).
There are no dosage adjustments provided in the manufacturer's labeling (has not been studied).
(For additional information see "Secukinumab: Pediatric drug information")
Enthesitis-related arthritis, active:
Children ≥4 years and Adolescents:
15 to <50 kg: SUBQ: 75 mg once weekly at weeks 0, 1, 2, 3, and 4, followed by 75 mg every 4 weeks.
≥50 kg: SUBQ: 150 mg once weekly at weeks 0, 1, 2, 3, and 4, followed by 150 mg every 4 weeks.
Plaque psoriasis, moderate to severe:
Children ≥6 years and Adolescents <18 years:
15 to <50 kg: SUBQ: 75 mg once weekly at weeks 0, 1, 2, 3, and 4, followed by 75 mg every 4 weeks (manufacturer's labeling).
≥50 kg: SUBQ: 150 mg once weekly at weeks 0, 1, 2, 3, and 4, followed by 150 mg every 4 weeks (manufacturer's labeling); some may require higher dose of 300 mg every 4 weeks (Cosentyx European Medicines Agency 2021).
Adolescents ≥18 years: SUBQ: 300 mg once weekly at weeks 0, 1, 2, 3, and 4, followed by 300 mg every 4 weeks. Some patients may only require 150 mg/dose (manufacturer's labeling).
Psoriatic arthritis:
Children ≥2 years and Adolescents <18 years:
15 to <50 kg: SUBQ: 75 mg once weekly at weeks 0, 1, 2, 3, and 4, followed by 75 mg every 4 weeks.
≥50 kg: SUBQ: 150 mg once weekly at weeks 0, 1, 2, 3, and 4, followed by 150 mg every 4 weeks.
Adolescents ≥18 years:
With a loading dose: SUBQ: 150 mg at weeks 0, 1, 2, 3, and 4 followed by 150 mg every 4 weeks; consider an increase to 300 mg every 4 weeks in patients who continue to have active psoriatic arthritis.
Without a loading dose: SUBQ: 150 mg every 4 weeks; consider an increase to 300 mg every 4 weeks in patients who continue to have active ankylosing spondylitis.
Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.
There are no dosage adjustments provided in the manufacturer's labeling (has not been studied).
There are no dosage adjustments provided in the manufacturer's labeling (has not been studied).
Refer to adult dosing.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Solution Auto-injector, Subcutaneous [preservative free]:
Cosentyx Sensoready (300 MG): 150 mg/mL (1 mL) [contains mouse (murine) and/or hamster protein, polysorbate 80]
Cosentyx Sensoready Pen: 150 mg/mL (1 mL) [contains polysorbate 80]
Solution Prefilled Syringe, Subcutaneous:
Cosentyx: 75 mg/0.5 mL (0.5 mL) [contains polysorbate 80]
Solution Prefilled Syringe, Subcutaneous [preservative free]:
Cosentyx: 150 mg/mL (1 mL) [contains polysorbate 80]
Cosentyx (300 MG Dose): 150 mg/mL (1 mL) [contains mouse (murine) and/or hamster protein, polysorbate 80]
No
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Solution, Subcutaneous:
Cosentyx: 150 mg/mL (1 mL) [contains mouse (murine) and/or hamster protein, polysorbate 80]
Solution Prefilled Syringe, Subcutaneous:
Cosentyx: 75 mg/0.5 mL (0.5 mL) [contains polysorbate 80]
An FDA-approved patient medication guide, which is available with the product information and as follows, must be dispensed with this medication:
Cosentyx: https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/125504s043lbl.pdf#page=24
SUBQ: Allow to reach room temperature 15 to 30 minutes prior to injection. Inject into the front of thighs, lower abdomen (≥2 inches away from the navel) or outer upper arms; administer each injection at a different anatomic location than a previous injection and avoid areas where the skin is tender, bruised, erythematous, indurated, or affected by psoriasis, or where there are scars or stretch marks. The Sensoready pen or prefilled syringe may be self-injected by the patient or caregiver following proper training in SUBQ injection technique.
The 300 mg dose should be divided into two 150 mg SUBQ injections.
Parenteral: SUBQ: Allow to reach room temperature prior to injection. Inject into the thighs, any quadrant of the abdomen (≥2 inches away from the navel), or outer upper arms; administer each injection at a different anatomic location than a previous injection and avoid areas where the skin is tender, bruised, erythematous, indurated, or affected by psoriasis, or where there are scars or stretch marks. Do not shake injection device. Pediatric doses of the Sensoready pen or prefilled syringe should be administered by an adult caregiver; trained adult patients may self-administer.
The 300 mg dose should be divided into two 150 mg SUBQ injections.
Ankylosing spondylitis: Treatment of active ankylosing spondylitis in adults.
Axial spondyloarthritis (nonradiographic): Treatment of active nonradiographic axial spondyloarthritis in adults with objective signs of inflammation.
Enthesitis-related arthritis: Treatment of active enthesitis-related arthritis in patients ≥4 years of age.
Plaque psoriasis: Treatment of moderate to severe plaque psoriasis in patients ≥6 years of age who are candidates for systemic therapy or phototherapy.
Psoriatic arthritis: Treatment of active psoriatic arthritis in patients ≥2 years of age.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.
>10%:
Infection: Infection (29% to 48%; serious infection: ≤1%)
Respiratory: Nasopharyngitis (11% to 12%)
1% to 10%:
Dermatologic: Urticaria (≤1%)
Endocrine & metabolic: Hypercholesterolemia (≥2%)
Gastrointestinal: Diarrhea (3% to 4%), inflammatory bowel disease (≤1%; Crohn’s disease, exacerbation of Crohn’s disease, exacerbation of ulcerative colitis, ulcerative colitis: <1%), mucocutaneous candidiasis (1%), nausea (≥2%), oral herpes simplex infection (≤1%)
Nervous system: Headache (≥2%)
Respiratory: Pharyngitis (1%), rhinitis (1%), rhinorrhea (≤1%), upper respiratory tract infection (3%)
Frequency not defined:
Gastrointestinal: Colitis, gastritis, hematochezia, lower abdominal pain
Genitourinary: Urinary tract infection
Hypersensitivity: Anaphylaxis, hypersensitivity reaction
Infection: Candidiasis, herpes virus infection, staphylococcal infection
<1%, postmarketing, and/or case reports: Antibody development (including neutralizing; neutralizing antibodies not associated with drug efficacy), conjunctivitis, impetigo, increased serum transaminases, neutropenia, oral candidiasis, otitis externa, otitis media, sinusitis, tinea pedis, tonsillitis
Serious hypersensitivity reaction to secukinumab or any component of the formulation
Concerns related to adverse effects:
• Hypersensitivity reactions: Urticaria and anaphylaxis have been reported; discontinue immediately if signs/symptoms of a serious hypersensitivity reaction develop and initiate appropriate treatment.
• Infections: Secukinumab may increase the risk of infections. Serious and sometimes fatal infections have been reported. A higher rate of infections was observed with secukinumab treatment in clinical trials, including nasopharyngitis, upper respiratory tract infection, and mucocutaneous candida infection; the incidence of some types of infection appeared to be dose-dependent. Use with caution in patients with a chronic infection or a history of recurrent infection. In patients who develop a serious infection, monitor closely and discontinue use until the infection resolves.
• Tuberculosis: Patients should be evaluated for tuberculosis infection prior to initiating therapy; avoid therapy in patients with an active tuberculosis infection. Consider antituberculosis therapy if an adequate course of treatment cannot be confirmed in patients with a history of latent or active tuberculosis. Monitor all patients for signs and symptoms of active tuberculosis during and after treatment.
Disease related concerns:
• Inflammatory bowel disease: Treatment with secukinumab may cause exacerbations (some serious) and new onset of inflammatory bowel of inflammatory bowel disease; monitor patients for signs and symptoms of inflammatory bowel disease.
Dosage form specific issues:
• Latex: Some dosage forms may contain dry natural rubber (latex).
• Polysorbate 80: Some dosage forms may contain polysorbate 80 (also known as Tweens). Hypersensitivity reactions, usually a delayed reaction, have been reported following exposure to pharmaceutical products containing polysorbate 80 in certain individuals (Isaksson 2002; Lucente 2000; Shelley 1995). Thrombocytopenia, ascites, pulmonary deterioration, and renal and hepatic failure have been reported in premature neonates after receiving parenteral products containing polysorbate 80 (Alade 1986; CDC 1984). See manufacturer's labeling.
Other warnings/precautions:
• Immunizations: Patients should be brought up to date with all immunizations before initiating therapy. Live vaccines should not be given concurrently during therapy; non-live vaccines administered during secukinumab therapy may not elicit an immune response sufficient to prevent disease.
Reactivation of tuberculosis (TB) has been reported in pediatric patients receiving biologic response modifiers (infliximab and etanercept); prior to therapy, patients with no TB risk factors should be screened for latent TB infection (LTBI) with an age appropriate test (ie, <5 years of age: Tuberculin skin test; ≥5 years of age: IGRA [interferon gamma release assay]); if any TB risk factors are present or symptoms, both LTBI screening tests should be performed (AAP [Davies 2016]).
None known.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.
Abrocitinib: May enhance the immunosuppressive effect of Immunosuppressants (Therapeutic Immunosuppressant Agents). Risk X: Avoid combination
Anifrolumab: Biologic Anti-Psoriasis Agents may enhance the immunosuppressive effect of Anifrolumab. Risk X: Avoid combination
Baricitinib: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the immunosuppressive effect of Baricitinib. Risk X: Avoid combination
BCG Products: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the adverse/toxic effect of BCG Products. Specifically, the risk of vaccine-associated infection may be increased. Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of BCG Products. Risk X: Avoid combination
Belimumab: May enhance the immunosuppressive effect of Biologic Anti-Psoriasis Agents. Risk X: Avoid combination
Brincidofovir: Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of Brincidofovir. Risk C: Monitor therapy
Cladribine: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the immunosuppressive effect of Cladribine. Risk X: Avoid combination
Coccidioides immitis Skin Test: Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the diagnostic effect of Coccidioides immitis Skin Test. Management: Consider discontinuing therapeutic immunosuppressants several weeks prior to coccidioides immitis skin antigen testing to increase the likelihood of accurate diagnostic results. Risk D: Consider therapy modification
COVID-19 Vaccine (Adenovirus Vector): Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of COVID-19 Vaccine (Adenovirus Vector). Management: Administer a 2nd dose using an mRNA COVID-19 vaccine (at least 4 weeks after the primary vaccine dose) and a bivalent booster dose (at least 2 months after the additional mRNA dose or any other boosters). Risk D: Consider therapy modification
COVID-19 Vaccine (Inactivated Virus): Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of COVID-19 Vaccine (Inactivated Virus). Risk C: Monitor therapy
COVID-19 Vaccine (mRNA): Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of COVID-19 Vaccine (mRNA). Management: Give a 3-dose primary series for all patients aged 6 months and older taking immunosuppressive medications or therapies. Booster doses are recommended for certain age groups. See CDC guidance for details. Risk D: Consider therapy modification
COVID-19 Vaccine (Subunit): Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of COVID-19 Vaccine (Subunit). Risk C: Monitor therapy
COVID-19 Vaccine (Virus-like Particles): Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of COVID-19 Vaccine (Virus-like Particles). Risk C: Monitor therapy
Dengue Tetravalent Vaccine (Live): Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the adverse/toxic effect of Dengue Tetravalent Vaccine (Live). Specifically, the risk of vaccine-associated infection may be increased. Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of Dengue Tetravalent Vaccine (Live). Risk X: Avoid combination
Denosumab: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the immunosuppressive effect of Denosumab. Management: Consider the risk of serious infections versus the potential benefits of coadministration of denosumab and immunosuppressants. If combined, monitor for signs/symptoms of serious infections. Risk D: Consider therapy modification
Deucravacitinib: May enhance the immunosuppressive effect of Immunosuppressants (Therapeutic Immunosuppressant Agents). Risk X: Avoid combination
Efgartigimod Alfa: May diminish the therapeutic effect of Fc Receptor-Binding Agents. Risk C: Monitor therapy
Filgotinib: May enhance the immunosuppressive effect of Immunosuppressants (Therapeutic Immunosuppressant Agents). Risk X: Avoid combination
Inebilizumab: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the immunosuppressive effect of Inebilizumab. Risk C: Monitor therapy
InFLIXimab: May enhance the immunosuppressive effect of Biologic Anti-Psoriasis Agents. Risk X: Avoid combination
Influenza Virus Vaccines: Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of Influenza Virus Vaccines. Management: Administer influenza vaccines at least 2 weeks prior to initiating immunosuppressants if possible. If vaccination occurs less than 2 weeks prior to or during therapy, revaccinate 2 to 3 months after therapy discontinued if immune competence restored. Risk D: Consider therapy modification
Leflunomide: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the immunosuppressive effect of Leflunomide. Management: Increase the frequency of chronic monitoring of platelet, white blood cell count, and hemoglobin or hematocrit to monthly, instead of every 6 to 8 weeks, if leflunomide is coadministered with immunosuppressive agents. Risk D: Consider therapy modification
Natalizumab: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the immunosuppressive effect of Natalizumab. Risk X: Avoid combination
Ocrelizumab: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the immunosuppressive effect of Ocrelizumab. Risk C: Monitor therapy
Ofatumumab: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the immunosuppressive effect of Ofatumumab. Risk C: Monitor therapy
Pidotimod: Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of Pidotimod. Risk C: Monitor therapy
Pimecrolimus: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the immunosuppressive effect of Pimecrolimus. Risk X: Avoid combination
Pneumococcal Vaccines: Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of Pneumococcal Vaccines. Risk C: Monitor therapy
Poliovirus Vaccine (Live/Trivalent/Oral): Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the adverse/toxic effect of Poliovirus Vaccine (Live/Trivalent/Oral). Specifically, the risk of vaccine-associated infection may be increased. Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of Poliovirus Vaccine (Live/Trivalent/Oral). Risk X: Avoid combination
Polymethylmethacrylate: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the potential for allergic or hypersensitivity reactions to Polymethylmethacrylate. Management: Use caution when considering use of bovine collagen-containing implants such as the polymethylmethacrylate-based Bellafill brand implant in patients who are receiving immunosuppressants. Consider use of additional skin tests prior to administration. Risk D: Consider therapy modification
Rabies Vaccine: Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of Rabies Vaccine. Management: Complete rabies vaccination at least 2 weeks before initiation of immunosuppressant therapy if possible. If combined, check for rabies antibody titers, and if vaccination is for post exposure prophylaxis, administer a 5th dose of the vaccine. Risk D: Consider therapy modification
Rubella- or Varicella-Containing Live Vaccines: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the adverse/toxic effect of Rubella- or Varicella-Containing Live Vaccines. Specifically, the risk of vaccine-associated infection may be increased. Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of Rubella- or Varicella-Containing Live Vaccines. Risk X: Avoid combination
Ruxolitinib (Topical): Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the immunosuppressive effect of Ruxolitinib (Topical). Risk X: Avoid combination
Sipuleucel-T: Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of Sipuleucel-T. Management: Consider reducing the dose or discontinuing the use of immunosuppressants prior to initiating sipuleucel-T therapy. Risk D: Consider therapy modification
Sphingosine 1-Phosphate (S1P) Receptor Modulator: May enhance the immunosuppressive effect of Immunosuppressants (Therapeutic Immunosuppressant Agents). Risk C: Monitor therapy
Tacrolimus (Topical): Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the immunosuppressive effect of Tacrolimus (Topical). Risk X: Avoid combination
Talimogene Laherparepvec: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the adverse/toxic effect of Talimogene Laherparepvec. Specifically, the risk of infection from the live, attenuated herpes simplex virus contained in talimogene laherparepvec may be increased. Risk X: Avoid combination
Tertomotide: Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of Tertomotide. Risk X: Avoid combination
Tofacitinib: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the immunosuppressive effect of Tofacitinib. Management: Coadministration of tofacitinib with potent immunosuppressants is not recommended. Use with non-biologic disease-modifying antirheumatic drugs (DMARDs) was permitted in psoriatic arthritis clinical trials. Risk X: Avoid combination
Typhoid Vaccine: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the adverse/toxic effect of Typhoid Vaccine. Specifically, the risk of vaccine-associated infection may be increased. Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of Typhoid Vaccine. Risk X: Avoid combination
Upadacitinib: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the immunosuppressive effect of Upadacitinib. Risk X: Avoid combination
Vaccines (Inactivated/Non-Replicating): Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of Vaccines (Inactivated/Non-Replicating). Management: Give inactivated vaccines at least 2 weeks prior to initiation of immunosuppressants when possible. Patients vaccinated less than 14 days before initiating or during therapy should be revaccinated at least 2 to 3 months after therapy is complete. Risk D: Consider therapy modification
Vaccines (Live): May enhance the adverse/toxic effect of Immunosuppressants (Therapeutic Immunosuppressant Agents). Specifically, the risk of vaccine-associated infection may be increased. Vaccines (Live) may diminish the therapeutic effect of Immunosuppressants (Therapeutic Immunosuppressant Agents). Risk X: Avoid combination
Yellow Fever Vaccine: Immunosuppressants (Therapeutic Immunosuppressant Agents) may enhance the adverse/toxic effect of Yellow Fever Vaccine. Specifically, the risk of vaccine-associated infection may be increased. Immunosuppressants (Therapeutic Immunosuppressant Agents) may diminish the therapeutic effect of Yellow Fever Vaccine. Risk X: Avoid combination
The American Academy of Dermatology considers secukinumab for the treatment of psoriasis to be likely compatible for use in male patients planning to father a child (AAD-NPF [Menter 2019]). Males and females with well-controlled psoriasis who are planning a pregnancy and wish to avoid fetal exposure can consider discontinuing secukinumab 19 weeks prior to attempting pregnancy (Rademaker 2018).
Based on limited information, use of secukinumab may be continued through conception in patients with rheumatic and musculoskeletal diseases who are planning to become pregnant and not able to use alternative therapies; use should be discontinued once pregnancy is confirmed. Conception should be planned during a period of quiescent/low disease activity. Recommendations for use of secukinumab to treat rheumatic and musculoskeletal diseases in patients who are planning to father a child are not available due to limited data (ACR [Sammaritano 2020]).
Possible failure of tubal sterilization following placement of an implantable birth control device (Essure) was observed in a female treated with secukinumab (Nardin 2018). Note: Distribution of Essure in the United States was stopped in December 2018.
Secukinumab is a humanized monoclonal antibody (IgG1). Placental transfer of human IgG is dependent upon the IgG subclass, maternal serum concentrations, birth weight, and gestational age, generally increasing as pregnancy progresses. The lowest exposure would be expected during the period of organogenesis (Palmeira 2012; Pentsuk 2009).
Outcome information following exposure to secukinumab during pregnancy is limited (Liu 2020; Nardin 2018; Warren 2018).
Until additional information is available, secukinumab is not currently recommended for the treatment of rheumatic and musculoskeletal diseases during pregnancy. Secukinumab should be discontinued once pregnancy is confirmed (ACR [Sammaritano 2020]). Agents other than secukinumab are preferred for the treatment of plaque psoriasis during pregnancy (Yeung 2020).
It is not known if secukinumab is present in breast milk.
According to the manufacturer, the decision to breastfeed during therapy should consider the risk of infant exposure, the benefits of breastfeeding to the infant, and the benefits of treatment to the mother. Treatment with secukinumab may be continued or initiated in breastfeeding patients with rheumatic and musculoskeletal diseases (ACR [Sammaritano 2020]).
CBC with differential (baseline); complete metabolic panel (baseline); tuberculosis (TB) screening prior to initiating and during therapy (chest x-ray if TB positive); hepatitis B virus (HBV)/hepatitis C virus screening prior to initiating (all patients), HBV carriers (during and for several months following therapy); HIV screening in high-risk patients (baseline) (AAD-NPF [Menter 2019]); signs and symptoms of infection or inflammatory bowel disease.
Secukinumab is a human IgG1 monoclonal antibody that selectively binds to the interleukin-17A (IL-17A) cytokine and inhibits its interaction with the IL-17 receptor. IL-17A is a naturally occurring cytokine involved in normal inflammatory and immune responses. Secukinumab inhibits the release of proinflammatory cytokines and chemokines.
Note: Weight: Secukinumab clearance and volume of distribution increase as body weight increases.
Onset of action: Psoriasis: Response best determined after 12 weeks (AAD-NPF [Menter 2019]).
Distribution: Vd: 7.1 to 8.6 L.
Metabolism: Expected to be degraded into small peptides and amino acids via catabolic pathways similar to that which is seen with endogenous IgG.
Bioavailability: 55% to 77%.
Half-life elimination: 22 to 31 days.
Time to peak: ~6 days.
Solution Auto-injector (Cosentyx Sensoready (300 MG) Subcutaneous)
150 mg/mL (per mL): $3,882.76
Solution Auto-injector (Cosentyx Sensoready Pen Subcutaneous)
150 mg/mL (per mL): $7,765.52
Solution Prefilled Syringe (Cosentyx (300 MG Dose) Subcutaneous)
150 mg/mL (per mL): $3,882.76
Solution Prefilled Syringe (Cosentyx Subcutaneous)
75 mg/0.5 mL (per 0.5 mL): $3,882.77
150 mg/mL (per mL): $7,765.52
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