Cosentyx® (secukinumab): Mechanism of action

The Cosentyx mechanism of action works by blocking IL-17A, a key proinflammatory cytokine associated with inflammation in axSpA, PsA, PsO and HS1–14

How does Cosentyx work?

The active ingredient, secukinumab, mechanism of action works by targeting IL-17A, preventing it from binding to the IL-17A receptor.^1,2 It acts downstream of several other biologics and inhibits IL-17A cytokines irrespective of adaptive or innate immunity origin.^17,18

Through blocking IL-17A, Cosentyx works across the key manifestations of axSpA, PsA, PsO and HS1–9

Cosentyx is intended for use under the guidance and supervision of a physician experienced in the diagnosis and treatment of conditions for which Cosentyx is indicated.  Please refer to the Cosentyx SmPC for full product information before prescribing.^1,2

Therapeutic indications^1,2

Cosentyx is indicated for the treatment of moderate to severe plaque psoriasis (PsO) in adults, children and adolescents from the age of 6 years who are candidates for systemic therapy; active psoriatic arthritis (PsA) in adult patients (alone or in combination with methotrexate [MTX]) when the response to previous disease-modifying anti-rheumatic drug therapy has been inadequate; active ankylosing spondylitis (AS) in adults who have responded inadequately to conventional therapy; active nonradiographic axial spondyloarthritis (nr-axSpA) with objective signs of inflammation as indicated by elevated C-reactive protein and/or magnetic resonance imaging evidence in adults who have responded inadequately to non-steroidal anti-inflammatory drugs; active moderate to severe hidradenitis suppurativa (HS; acne inversa) in adults with an inadequate response to conventional systemic HS therapy; active enthesitis-related arthritis (ERA) in patients 6 years and older (alone or in combination with MTX) whose disease has responded inadequately to, or who cannot tolerate, conventional therapy; active juvenile psoriatic arthritis (JPsA) in patients 6 years and older (alone or in combination with MTX) whose disease has responded inadequately to, or who cannot tolerate, conventional therapy.^1,2

CLEAR was a Phase IIIb randomised, double-blind, head-to-head study comparing Cosentyx 300 mg (n=337) to ustekinumab 45 mg or 90 mg (n=339) over 52 weeks in patients with moderate to severe PsO. The primary endpoint was PASI 90 at Week 16. The main secondary endpoint was PASI 90 at Year 1. PASI 75/90/100 over time were also evaluated.¹⁹

AS, ankylosing spondylitis; axSpA, axial spondyloarthritis; BAD, British Association of Dermatologists; BSR, British Society for Rheumatology; ERA, enthesitis-related arthritis; GRAPPA, Group for Research and Assessment of Psoriatic Arthritis; HS, hidradenitis suppurativa; IL-17A, interleukin 17A; IL-23, interleukin 23; JPsA, juvenile psoriatic arthritis; MTX, methotrexate; NK, natural killer; PASI, psoriasis area and severity index; PsA, psoriatic arthritis; PsO, plaque psoriasis; SmPC, summary of product characteristics; TNF, tumour necrosis factor.

References

1. Cosentyx® (secukinumab) GB Summary of Product Characteristics. Available at: https://www.medicines.org.uk/emc/product/3669/smpc [Accessed February 2024].
2. Cosentyx® (secukinumab) NI Summary of Product Characteristics. Available at: https://www.emcmedicines.com/en-gb/northernireland/medicine?id=ecdc7f05-... [Accessed February 2024].
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