by Cosentyx (secukinumab) is a human monoclonal antibody that selectively binds to and inhibits interleukin-17A (IL-17A). IL-17A is a naturally occurring cytokine involved in normal inflammatory and immune responses. Cosentyx drug was developed by Novartis Pharmaceuticals and was approved by the FDA in 2015 for the treatment of moderate to severe plaque psoriasis and psoriatic arthritis.
Treatment of Plaque Psoriasis
In clinical trials evaluating Cosentyx for the treatment of plaque psoriasis, it demonstrated high rates of skin clearance and maintained clinical responses for up to 4 years with continuous treatment. One phase 3 trial found that after 12 weeks of treatment, 82.1% of patients receiving Cosentyx 300 mg achieved Psoriasis Area and Severity Index 90 (PASI 90) skin clearance compared to 3.1% receiving placebo. At week 52, 68.8% of patients maintained PASI 90 response with continued Cosentyx drug treatment. Similar results were seen in other trials, confirming Cosentyx as a highly effective treatment for plaque psoriasis when administered as a monthly subcutaneous injection.
Common side effects during psoriasis treatment included injection site reactions, upper respiratory infections, and diarrhea. However, the side effect profile was mild. Serious adverse events were rare. Long-term safety analyses found no new or increased risks over time. Cosentyx proved to be well-tolerated and provided long-lasting skin clearance for many plaque psoriasis patients.
Treatment of Psoriatic Arthritis
In clinical trials involving patients with active psoriatic arthritis, Cosentyx drug treatment led to significant improvements in both skin symptoms and joint symptoms. After 16 weeks, twice as many Cosentyx-treated patients achieved American College of Rheumatology 20 (ACR20) response compared to placebo-treated patients. Mean reductions in tender and swollen joint counts, patient global assessment, pain scores, and physical function were also significantly greater with Cosentyx versus placebo. Cosentyx decreased disease activity and provided relief of both skin and musculoskeletal symptoms of psoriatic arthritis.
Studies have continued evaluating Cosentyx for psoriatic arthritis out to 5 years, demonstrating sustained clinical benefit with long-term treatment. Patients who achieved at least 20% improvement in swollen and tender joint counts at weeks 16 and 24 were able to maintain response through 5 years with continuous Cosentyx therapy. Quality of life measures also remained significantly improved versus baseline. Cosentyx provides a needed new treatment option for the effective long-term management of psoriatic arthritis.
Place in Therapy and Patient Considerations
Cosentyx fills an important role for patients who have failed to achieve adequate disease control or experienced adverse effects with traditional systemic therapies like methotrexate, cyclosporine, or biologics such as TNF inhibitors. For many patients, Cosentyx drug offers a favorable benefit-risk profile compared to other available treatments. As an IL-17A antagonist, it has a differentiated mechanism of action that may provide benefits even in those who don’t respond sufficiently to TNF inhibitors.
When considering Cosentyx, patients should be aware that while it provides rapid and significant skin and joint improvements, injections are required monthly which may be less convenient than oral therapies. They should also understand the need for continuous treatment to maintain response. Cosentyx has boxed warnings for infections and pre-treatment screening is required due to a possible increased risk of candida infections. Overall, its favorable long-term efficacy and safety make Cosentyx a good option where appropriate for many psoriasis and psoriatic arthritis patients.
Cosentyx has become an essential new treatment in dermatology and rheumatology for patients with moderate to severe plaque psoriasis or active psoriatic arthritis based on consistently robust results from clinical trials. It offers favorable skin clearance and control of joint symptoms sustained out to 5 years of treatment. Cosentyx has proven to be well-tolerated with a manageable safety profile. For suitable patients who require an effective biologic therapy, Cosentyx drug provides an important new option for achieving disease control, improved quality of life, and long-term management of psoriasis and associated psoriatic arthritis.
