Cosentyx® Secukinumab SEC
Human monoclonal IgG1 antibody, binds and blocks IL-17A
Medium to severe plaque psoriasis, approved from 18 years of age (PASI>10/BSA>10/DLQI>10, according to Swiss S1 guidelines). Available as syringe or PEN
Treatment of adult patients with severe psoriasis (Def. in USZ and Swiss S1 Guideline): PASI > 10 or BSA > 10 and/or DLQI > 10) in which UVB and PUVA or one of the following three systemic therapies (ciclosporin, methotrexate, acitretin) have not shown therapeutic success. In iximab, additional failure of another TNF blocker approved for psoriasis
Pre-filled syringe, pen
Blood count, liver enzymes, creatinine, U status, pregnancy test in urine, CRP/ ESR. Screening for HBV, HCV, HIV and tuberculosis including Rx thorax.
Blood count, CRP, transaminases, creatinine, possibly β-HCG
Every three months
Every three months
300 mg in week 0, 1, 2, 3, 4, repeated every month (approx. 4 weeks). Attention, two syringes are required for 300 mg.
2 - 3 weeks
Week 12: 75 - 87 % Week 16: 86 % (300 mg)
Week 12: 59.2 % Week 16: 69.8 % (300 mg)
> 90 % achieve PASI 75 again after 12 - 16 weeks of re-treatment
PASI, (use PrecisePASI for greater accuracy once PASI < 10), DLQI after 12 and 24 weeks
Absolute contraindications: Active tuberculosis or acute, severe infections, live vaccinations, active chronic hepatitis B, pregnancy and breastfeeding. Relative contraindications: Crohn's disease (engombolic monitoring). Malignant diseases (except BCC and lymphoproliferative diseases).
Upper respiratory infections, rhinitis, rhinorrhoea, oral herpes, diarrhoea, urticaria, neutropenia, oral candidiasis, tinea pedis, esophageal candidiasis, conjunctivitis, elevated liver values, elevated bilirubin, immunogenicity, exacerbation in Crohn's disease, anaphylaxis, skin infections with staphylococci
Dose of medication interacting with CYP450 3A4, 1A2, or 2C9 should be re-evaluated.