Anti-IL-17A Monoclonal Antibody Pregnancy: Avoid — insufficient data

Secukinumab

Brand names: Cosentyx

Adult dose

Dose: Psoriasis: 300 mg SC at weeks 0, 1, 2, 3, 4, then every 4 weeks. Psoriatic arthritis/AS: 150–300 mg SC monthly.

Route: Subcutaneous

Frequency: Weekly loading × 5 doses, then monthly

Max: 300 mg monthly

For moderate-severe plaque psoriasis, psoriatic arthritis, and ankylosing spondylitis. NICE TA350/TA645. Screen for TB before starting.

Route: SC

Frequency: Loading then monthly

Max: Paediatric psoriasis (≥6 years): 75–150 mg per schedule

Concentration: 150 mg/mL prefilled syringe mg/ml

Paediatric plaque psoriasis ≥6 years: weight-based dosing; 75 mg (<25 kg) or 150 mg (≥25 kg and <50 kg) or 150 mg (>50 kg, same as adults).

Renal

No dose adjustment required

Hepatic

No dose adjustment required

CLEAR trial: secukinumab superior to ustekinumab for psoriasis (skin clearance at 16 weeks)
IBD risk: may worsen Crohn's disease — screen for IBD symptoms before starting and monitor
Mucosal candidiasis: common but usually mild — treat as needed without stopping secukinumab
TB screening before starting: IGRA/Mantoux + CXR

Live vaccines — avoid
CYP450 substrates — secukinumab may normalise CYP activity (reduced by IL-17 inflammation) — monitor warfarin/ciclosporin if added to established therapy

Reference: BNFc; BNF; NICE TA350; CLEAR Trial. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

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