What is secukinumab?

Why is secukinumab prescribed?

What are the possible side-effects?

What else should I know about secukinumab?

What is secukinumab?

Secukinumab (trade name Cosentyx) is a type of drug known as an interleukin-17A (IL-17A) inhibitor. IL-17A is an immune molecule found in our blood. In people with psoriatic arthritis and ankylosing spondylitis, IL-17A is overproduced in the body causing inflammation and joint damage. This can result in stiff and painful joints and restricted movement as seen in people with psoriatic arthritis and ankylosing spondylitis. Secukinumab binds to IL-17A and blocks its effect, helping to improve these symptoms.

What type of drug is secukinumab?

Secukinumab is an IL-17A (interleukin-17A) inhibitor drug.

What does it do?

It blocks the action of IL-17A in the body, reducing inflammation in the joints.

What is it used for?

Secukinumab is used to treat psoriatic arthritis and ankylosing spondylitis in adults.

How is it taken?

It is given as an injection under the skin (subcutaneous).

Are there any side-effects?

Secukinumab works on the immune system (the body’s own defence system) so the most common side-effect with secukinumab is that it can make you more likely to develop infections.

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Why is secukinumab prescribed?

Secukinumab is available for adults with psoriatic arthritis and ankylosing spondylitis. Secukinumab will only be prescribed if your psoriatic arthritis is active and if your response to previous disease-modifying anti-rheumatic drugs (DMARDs) has been inadequate in improving your symptoms, or if you cannot use DMARDS. Secukinumab will only be prescribed if your ankylosing spondylitis is active.

Is there any reason I will not be prescribed secukinumab?

Your doctor will not prescribe secukinumab if:

  • You have an active infection that your doctor thinks is relevant

Your doctor may decide not to prescribe secukinumab if:

  • You have had tuberculosis (TB) in the past
  • You have had other repeated infections
  • You are sensitive to latex
  • You have Crohn’s disease
  • You are pregnant or breastfeeding

When and how do I take secukinumab?

Secukinumab is only available on prescription from a consultant rheumatologist. For people with psoriatic arthritis:

  • The usual dose of secukinumab is either 300mg or 150mg. Your doctor will decide what dose you should take. Each 300mg dose is given as two injections of 150mg each, and each 150mg dose is given as one injection.
  • You will receive one dose per week for the initial 5 weeks (weeks 0, 1, 2, 3, 4) of your treatment. After this you will receive one dose per month.

For people with ankylosing spondylitis:

  • The usual dose of secukinumab is 150mg. This is given as one injection.
  • You will receive one dose per week for the initial 5 weeks (weeks 0, 1, 2, 3, 4) of your treatment. After this you will receive one dose per month.

Secukinumab is given as an injection under the skin (a subcutaneous injection). You, your partner or another member of your family can learn to give the injection. If this is not possible, you should consult your rheumatology nurse specialist or public health nurse.

How long does secukinumab take to work?

If you respond to secukinumab, you may start to feel better as early as 2 weeks after beginning treatment. However, it could take up to 16 weeks to feel better, so it is important to continue treatment.

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What are the possible side-effects?

Secukinumab works on the immune system (the body’s own defence system) which can mean you are more likely to develop infections.

You should let your doctor or rheumatology nurse know if you develop any of the following symptoms:

  • a sore throat
  • a fever
  • any other new symptoms or anything else that concerns you

What should I look out for?

You should stop secukinumab and see your doctor immediately if:

You develop any signs of possible serious infection including:

  • fever, flu-like symptoms, night sweats
  • feeling tired or short of breath, cough which will not go away
  • warm, red and painful skin, or a painful skin rash with blisters
  • burning sensation when passing urine

You develop any signs of serious allergic reaction including:

  • difficulty breathing or swallowing
  • low blood pressure, which can cause dizziness or light headedness
  • swelling of the face, lips, tongue or throat
  • severe itching of the skin, with a red rash or raised bumps

You should always read the patient information leaflet included with your medicines package to keep you informed about any possible side effects of your prescribed medications.

How can I reduce the risk of infection?

Because of its effects on the immune system, secukinumab may make you more likely to pick up infections. You should try to avoid close contact with people with severe active infections.

You may also find it useful to visit the Food Safety Authority of Ireland website (www.fsai.ie) for general information on reducing risk of infection from foods, though there is no research to show a specific association between use of secukinumab and increased risk of food-borne infections.

Will it affect vaccinations?

If you are taking secukinumab it is recommended that you avoid live vaccines such as yellow fever, measles and mumps.

If you have recently had or are due to have a live vaccination, you should let your doctor, nurse or pharmacist know. You can have the influenza (flu) and pneumococcal vaccines as normal while using secukinumab.

Can I drink alcohol while using secukinumab?

You can drink alcohol while on secukinumab however alcohol consumption should not exceed the recommended amounts (1-2 units per day for women and 2-3 units per day for men). Your doctor may advise lower limits.

Does secukinumab affect fertility or pregnancy?

If you are thinking of having a baby or if you become pregnant, you should discuss this with your rheumatologist. At present, there is limited information on the use of secukinumab during pregnancy and on how it might affect an unborn baby.

Similarly, the effects of secukinumab on men trying to father a child are uncertain.

If you are a women of childbearing age you are advised to avoid becoming pregnant and should use an effective method of contraception while on secukinumab and for at least 20 weeks after stopping secukinumab.

Women who are planning to become pregnant should stop using secukinumab and use an effective method of contraception for 20 weeks after stopping secukinumab.

Does secukinumab affect breastfeeding?

It is not recommended that you breastfeed while using secukinumab.

If you wish to breastfeed you should inform your doctor and they can discuss the benefits of breastfeeding versus the benefits of using secukinumab.

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What else should I know about secukinumab?

If you are being prescribed secukinumab it is recommended that you carry a biological therapy alert card, which you can get from your doctor or rheumatology nurse. Then if you become unwell, anyone treating you will know that you are on secukinumab and that you are therefore at risk of its side-effects, including infections

Are there any alternatives?

A number of other drugs are used in the treatment of plaque psoriasis, psoriatic arthritis and ankylosing spondylitis. Your rheumatologist and rheumatology nurse will discuss these other options with you.

Will I need any special checks while on secukinumab?

Secukinumab should not be prescribed if you have an active infection so you may have blood tests and a chest x-ray before starting treatment. You may also have further blood tests while you are on secukinumab to monitor its effects.

Can I take other medicines alongside secukinumab?

Secukinumab may be prescribed along with other drugs, including methotrexate. You should discuss all current and any potential new medications with your doctor, and you should always tell any other doctor treating you that you are on secukinumab.

Can I continue with secukinumab if I am going to have an operation?

If you are going to have an operation, you should inform your doctor or specialist nurse, as you may be advised to stop secukinumab temporarily before and after surgery.

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