Secukinumab

Cosentyx® Secukinumab

Novartis

Human monoclonal IgG1 antibody that binds to and blocks IL-17A.

Moderate to severe plaque psoriasis (from 6 years of age), psoriatic arthritis in adults, juvenile psoriatic arthritis (from 6 years of age).

Yes

Treatment of adult patients with severe plaque psoriasis (as defined by the USZ and the Swiss S1 guideline: PASI > 10 or BSA > 10 and/or DLQI over 10), in whom UVB and PUVA or one of the following three systemic therapies (ciclosporin, methotrexate, acitretin) have not been successful. Active psoriatic arthritis that has responded inadequately to treatment for plaque psoriasis with one or more DMARDs, or which has not been tolerated by the patient.

Pre-filled syringe, pre-filled pen.

Differential blood count, liver function tests, creatinine, urinalysis, pregnancy test, CRP, screening for HBV, HCV, HIV and TB (optional: including chest X-ray).

Not necessary, only clinically.

Every 6 months, clinical only.

s.c.

Weeks 0, 1, 2, 3, 4, then once a month

Moderate to severe plaque psoriasis:

6–18 years: 75 mg (<50 kg) 150 mg (≥50 kg)

>18 years: 300 mg (≥90 kg: possibly every 2 weeks instead of every 4 weeks as a maintenance dose)

Active psoriatic arthritis:

>18 years: 150 mg (may be increased to 300 mg over time)

Juvenile psoriatic arthritis:

Ages 6–18: 75 mg (15 kg–<50 kg) 150 mg (≥50 kg)

If no therapeutic success has been achieved after 12 weeks, the treatment should be discontinued.

Week 12: 75 per cent – 87 per cent

Week 16: 86 per cent (300 mg)

Week 12: 59.2 per cent

Week 16: 69.8 per cent (300 mg)

Chronic inflammatory bowel diseases: Exacerbations were observed more frequently in patients with ulcerative colitis or Crohn’s disease than in the control group.

17,289 (21,612)

> 90 per cent achieve PASI 75 again following retreatment after 12–16 weeks.

PASI (use PrecisePASI for greater accuracy,
if PASI < 10), BSA and DLQI after 12 and 24 weeks.

<1 %

Absolute contraindications: active tuberculosis or acute, severe infections, live vaccines, active chronic hepatitis B, pregnancy and breastfeeding.

Relative contraindications: Crohn’s disease (close monitoring), malignant diseases (except basal cell carcinoma and lymphoproliferative disorders).

Upper respiratory tract infections, rhinitis, rhinorrhoea, oral herpes, diarrhoea, urticaria, neutropenia, candidiasis including oral/oesophageal candidiasis, tinea pedis, conjunctivitis, elevated liver enzymes, elevated bilirubin, immunogenicity, exacerbation of Crohn’s disease, anaphylaxis, staphylococcal skin infections.

Insufficient data

Discontinuation of treatment in the event of a lack of response to standard anti-infective therapy for HBV/HBC/HIV (in accordance with Swissmedic).

Insufficient data

The dosage of medicines that interact with CYP450 3A4, 1A2 or 2C9 should be reassessed.

Requires treatment with isoniazid and vitamin B6 for 9 months; treatment with a biologic may be started after 1 month.

Insufficient data