Secukinumab

Primary regimen above is adult plaque psoriasis. Based on clinical response, a maintenance dose of 300 mg every 2 weeks may provide additional benefit in patients weighing 90 kg or more. Other indications (UK SPC §4.2): Hidradenitis suppurativa — 300 mg at weeks 0, 1, 2, 3 and 4 then monthly; based on clinical response the maintenance dose can be increased to 300 mg every 2 weeks. Psoriatic arthritis — for patients with concomitant moderate to severe plaque psoriasis use the plaque psoriasis regimen; for anti-TNF-alpha inadequate responders 300 mg at weeks 0, 1, 2, 3, 4 then monthly; for other patients 150 mg on the same schedule, increased to 300 mg based on clinical response. Ankylosing spondylitis (radiographic axial spondyloarthritis) — 150 mg at weeks 0, 1, 2, 3, 4 then monthly, increased to 300 mg based on clinical response. Non-radiographic axial spondyloarthritis — 150 mg at weeks 0, 1, 2, 3, 4 then monthly. For all indications, clinical response is usually achieved within 16 weeks; consider discontinuing in patients with no response by 16 weeks, though some with an initial partial response may improve beyond 16 weeks. No dose adjustment required in patients aged 65 and over. PAEDIATRIC (weight-band, not per-kg — do not compute a per-kg dose): paediatric plaque psoriasis from age 6 years — <25 kg: 75 mg; 25 to <50 kg: 75 mg; ≥50 kg: 150 mg (may be increased to 300 mg, as some patients derive additional benefit from the higher dose); given at weeks 0, 1, 2, 3, 4 then monthly. Juvenile idiopathic arthritis (enthesitis-related arthritis and juvenile psoriatic arthritis) — <50 kg: 75 mg; ≥50 kg: 150 mg, on the same schedule. The 150 mg and 300 mg pre-filled syringe and pre-filled pen are NOT indicated for paediatric patients weighing <50 kg. Safety and efficacy below 6 years (plaque psoriasis, ERA, JPsA) and below 18 years in all other indications have not been established. Administration: avoid injecting into areas of skin showing psoriasis; do not shake the syringe or pen; patients/caregivers may self-inject after proper training if the physician considers it appropriate.