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Anti-IL-17A Monoclonal Antibody Pregnancy: B

Secukinumab

Brand names: Cosentyx

Adult dose

Dose: 150–300 mg SC at weeks 0, 1, 2, 3, 4 then every 4 weeks (PsA/AS); 300 mg with loading (psoriasis)
Route: subcutaneous injection
Frequency: Weekly × 5 (loading); then every 4 weeks
Max: 300 mg every 4 weeks
Available as prefilled syringe (1 mL) or autoinjector (SensoReady pen); 150 mg for AS without psoriasis; 300 mg for psoriasis and PsA

Paediatric dose

Route: subcutaneous
Frequency: every 4 weeks
Max: 150 mg
Concentration: 150 mg/mL prefilled syringe mg/ml
Paediatric plaque psoriasis ≥6 years: 75 mg (<25 kg) or 150 mg (≥25 kg) every 4 weeks; JIA not yet licensed

Dose adjustments

Renal

No dose adjustment required

Hepatic

No dose adjustment required

Clinical pearls

  • FUTURE trials: superior to placebo for PsA; MEASURE trials for AS
  • CLEAR trial: superior to ustekinumab in head-to-head psoriasis comparison
  • Contraindicated in active Crohn's disease — IL-17 inhibition can worsen IBD

Contraindications

  • Active Crohn's disease (may worsen)
  • Active severe infections
  • Live vaccines

Side effects

  • Nasopharyngitis
  • URTI
  • Headache
  • Diarrhoea
  • Candida infections
  • Inflammatory bowel disease (worsening or new onset)
  • Neutropenia

Interactions

  • Live vaccines (CI)
  • CYP450 substrates (warfarin, ciclosporin — monitor levels at initiation)

Monitoring

  • Signs of infection
  • Candida infections
  • IBD symptoms
  • FBC

Reference: BNFc; BNF 86; NICE TA415/TA408; FUTURE trials. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

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