Cosentyx

Uses

Cosentyx is a human interleukin-17A antagonist used for the treatment of:

• Moderate to severe plaque psoriasis in adult patients who are candidates for systemic therapy or phototherapy
• Adults with active psoriatic arthritis (PsA)
• Adults with active ankylosing spondylitis (AS)

Cosentyx is also used to associated treatment for these conditions: Ankylosing Spondylitis (AS), Psoriatic Arthritis, Severe Plaque psoriasis, Moderate Plaque psoriasis

How Cosentyx works

Cosentyx is a human monoclonal antibody that targets IL-17A cytokine to downregulate inflammation in psoriasis, an autoimmune dermatological disease. The pathophysiology of psoriasis has not been fully established, however it is known that dysregulation of innate and adaptive immune responses plays part in the chronic inflammation associated with the disease. IL-17 represents is a six-membered family (IL-17A to F) of pleiotropic pro-inflammatory cytokines, expression of which is found to be elevated in psoriatic skin. These cytokines act on many different cell types and provide defense against different extracellular pathogens causing fungal or bacterial infections. IL-17 cytokines are produced by many cells involved in immune system defense, such as Th17, mast cells, neutrophils, and dendritic cells - all implicated in promoting inflammation. There is evidence linking IL-17 to pathogenesis of multiple autoimmune diseases including rheumatoid arthritis, spondyloarthritis, psoriasis, Crohn's disease, multiple sclerosis, and even atherosclerosis.

Dosage

Cosentyx dosage

Plaque Psoriasis-

1. Recommended dosage is 300 mg by subcutaneous injection at Weeks 0, 1, 2, 3, and 4 followed by 300 mg every 4 weeks. For some patients, a dose of 150 mg may be acceptable.

Psoriatic Arthritis-

1. For psoriatic arthritis patients with coexistent moderate to severe plaque psoriasis, use the dosage and administration for plaque psoriasis.

2. For other psoriatic arthritis patients administer with or without a loading dosage. The recommended dosage:

• With a loading dosage is 150 mg at weeks 0, 1, 2, 3, and 4 and every 4 weeks thereafter
• Without a loading dosage is 150 mg every 4 weeks
• If a patient continues to have active psoriatic arthritis, consider a dosage of 300 mg.

• With a loading dosage is 150 mg at weeks 0, 1, 2, 3, and 4 and every 4 weeks thereafter
• Without a loading dosage is 150 mg every 4 weeks

Side Effects

Most common adverse reactions (greater than 1%) are nasopharyngitis, diarrhea, and upper respiratory tract infection.

Precaution

Infections: Serious infections have occurred. Caution should be exercised when considering the use of secukinumab in patients with a chronic infection or a history of recurrent infection. If a serious infection develops, discontinue secukinumab until the infection resolves.

Tuberculosis (TB): Prior to initiating treatment with secukinumab, evaluate for TB.

Inflammatory Bowel Disease: Cases of inflammatory bowel disease were observed in clinical trials. Caution should be exercised when prescribing secukinumab to patients with inflammatory bowel disease.

Hypersensitivity Reactions: If an anaphylactic reaction or other serious allergic reaction occurs, discontinue secukinumab immediately and initiate appropriate therapy.

Interaction

Live vaccines should not be given with Cosentyx

Food Interaction

Cosentyx Drug Interaction

Unknown: acetaminophen / codeine, charcoal, amphetamine / dextroamphetamine, amphetamine / dextroamphetamine, contained in alcoholic beverages , meclizine, lidocaine topical, hydroxyzine, lorazepam, sulfamethoxazole / trimethoprim, ubiquinone, heparin, esomeprazole, morphine, acetaminophen, bioflavonoids, vitamin a topical, bioflavonoids, sotalol, cyanocobalamin

Cosentyx Disease Interaction

Major: immunizationModerate: infections, tuberculosis, inflammatory bowel disease

Volume of Distribution

Volume of distribution (Vd) in interstitial fluid of skin (+/- psoriasis) was 27-40% of that in serum after single subcutaneous dose of 300 mg. Vd increased at higher body weights.

Elimination Route

Bioavailability after subcutaneous administration was 55-77%.

Half Life

22-31 days

Clearance

Serum clearance was increased with higher body weights.

Pregnancy & Breastfeeding use

Pregnancy: Limited available human data with secukinumab use in pregnant women are insufficient to inform a drug associated risk of adverse developmental outcomes. In an embryo-fetal development study, no adverse developmental effects were observed in infants born to pregnant monkeys after subcutaneous administration of secukinumab during organogenesis at doses up to 30 times the maximum recommended human dose

Lactation: It is not known whether secukinumab is excreted in human milk or absorbed systemically after ingestion. There are no data on the effects of secukinumab on the breastfed child or the effects on milk production. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for secukinumab and any potential adverse effects on the breastfed child from secukinumab or from the underlying maternal condition.

Contraindication

Serious hypersensitivity reaction to secukinumab or to any of the excipients.

Acute Overdose

Doses up to 30 mg/kg intravenously have been administered in clinical trials without dose-limiting toxicity. In the event of overdosage, it is recommended that the patient be monitored for any signs or symptoms of adverse reactions and appropriate symptomatic treatment be instituted immediately.

Storage Condition

Cosentyx Sensoready pens, prefilled syringes and vials must be refrigerated at 2ºC to 8ºC. Keep the product in the original carton to protect from light until the time of use. Do not freeze. To avoid foaming do not shake. Cosentyx does not contain a preservative; discard any unused portion.

Innovators Monograph

You find simplified version here Cosentyx