Secukinumab

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Secukinumab
Autoinjector with Cosentyx by Novartis (Secukinumab)
Monoclonal antibody
TypeWhole antibody
SourceHuman
TargetIL17A
Clinical data
Trade namesCosentyx
Other namesAIN457
AHFS/Drugs.comMonograph
MedlinePlusa615011
License data
Pregnancy
category
  • AU: C
Routes of
administration		Subcutaneous, intravenous
ATC code
Legal status
Legal status
Identifiers
CAS Number
DrugBank
ChemSpider
  • none
UNII
KEGG
Chemical and physical data
FormulaC6584H10134N1754O2042S44
Molar mass147944.37 g·mol−1
 ☒NcheckY (what is this?)  (verify)

Secukinumab, sold under the brand name Cosentyx among others, is a human IgG1κ monoclonal antibody used for the treatment of psoriasis, ankylosing spondylitis, and psoriatic arthritis.[4][5][6] It binds to the protein interleukin (IL)-17A and is marketed by Novartis.[4][5][6]

Medical uses[edit]

Secukinumab is used to treat psoriasis, ankylosing spondylitis, and psoriatic arthritis.[4][5][6][7] It is given by subcutaneous injection and is sold in a pre-filled syringe or autoinjector that can be used at home and as a lyophilized powder for use in hospitals and clinics.[5] In October 2023, the FDA approved a intravenous variant of secukinumab.[8]

Secukinumab was not tested in pregnant women; animal studies did not show harm at relevant doses. The US Food and Drug Administration advises that the drug should be used in pregnant women only if the risk to the fetus is justified by the potential benefit;[5] the European Medicines Agency (EMA) advises that women should not become pregnant while taking it.[4]

In the European Union, secukinumab is indicated for the treatment of:[6]

  • moderate to severe plaque psoriasis in adults, children and adolescents from the age of six years who are candidates for systemic therapy.[6]
  • active psoriatic arthritis in adults, alone or in combination with methotrexate (MTX), when the response to previous disease modifying anti rheumatic drug (DMARD) therapy has been inadequate.[6]
  • active ankylosing spondylitis in adults who have responded inadequately to conventional therapy.[6]
  • active non-radiographic axial spondyloarthritis with objective signs of inflammation as indicated by elevated C-reactive protein (CRP) and/or magnetic resonance imaging (MRI) evidence in adults who have responded inadequately to non steroidal anti inflammatory drugs (NSAIDs).[6]
  • active moderate to severe hidradenitis suppurativa in adults with an inadequate response to conventional systemic HS therapy.[6]
  • active enthesitis-related arthritis in patients 6 years and older whose disease has responded inadequately to, or who cannot tolerate, conventional therapy.[6]
  • active juvenile psoriatic arthritis in patients 6 years and older whose disease has responded inadequately to, or who cannot tolerate, conventional therapy.[6]

Adverse effects[edit]

Very common (greater than 10% of people experience them) adverse effects include upper respiratory tract infections.[4]

Common (between 1% and 10% of people experience them) include oral herpes, runny nose, and diarrhea.[4] Injection site reactions are common, occurring in approximately 1.9% of cases.[9]

In clinical trials there were rare instances of hypersensitivity reactions, severe infections, and some cases of serious inflammatory bowel disease, some of which were new and some of which were exacerbations of existing conditions.[5] Caution should be used when starting secukinumab in patients with inflammatory bowel disease, and patients being treated with secukinumab should be monitored for signs and symptoms of inflammatory bowel disease.[10]

Pharmacology[edit]

Secukinumab inhibits a member of the cytokine family, interleukin 17A, which is produced mainly by inflammatory T helper 17 cells.[11] IL17A is upregulated in serum of people with psoriasis and in the synovial fluid of people with psoriatic arthritis, and promotes inflammation when it binds to the interleukin-17 receptor which is expressed in various types of cells, including keratinocytes in skin.[11][12]

It is mostly eliminated by being taken up into cells via endocytosis and being broken down inside them.[4]

Chemistry[edit]

Secukinumab is a recombinant fully human IgG1/kappa monoclonal antibody and is manufactured in Chinese hamster ovary cells.[4]

History[edit]

Secukinumab was discovered and developed by Novartis using developmental name AIN457, and the first publication was a Phase I trial published in 2010.[13][14][15][16]

In January 2015, secukinumab was approved in the United States and in the European Union to treat adults with moderate-to-severe plaque psoriasis.[17][18][6] It is the first IL17A inhibiting drug ever approved.[12] In January 2016, the FDA approved it to treat adults with ankylosing spondylitis, and psoriatic arthritis and in February 2018, a label update was approved to include the treatment for moderate-to-severe scalp psoriasis.[19][20]

References[edit]

  1. ^ "Cosentyx (Novartis Pharmaceuticals Australia Pty Ltd)". Therapeutic Goods Administration (TGA). 7 October 2022. Retrieved 9 April 2023.
  2. ^ "Prescription medicines: registration of new chemical entities in Australia, 2015". Therapeutic Goods Administration (TGA). 21 June 2022. Retrieved 10 April 2023.
  3. ^ "Health Canada New Drug Authorizations: 2015 Highlights". Health Canada. 4 May 2016. Retrieved 7 April 2024.
  4. ^ a b c d e f g h i "Cosentyx 150mg and 300mg solution for injection in pre-filled syringe and pre-filled pen - Summary of Product Characteristics (SmPC)". (emc). 6 June 2022. Retrieved 9 November 2022.
  5. ^ a b c d e f g "Cosentyx- secukinumab injection". DailyMed. 4 November 2022. Retrieved 9 November 2022.
  6. ^ a b c d e f g h i j k l m "Cosentyx EPAR". European Medicines Agency (EMA). 17 September 2018. Retrieved 7 May 2020. Text was copied from this source which is © European Medicines Agency. Reproduction is authorized provided the source is acknowledged.
  7. ^ Patel NU, Vera NC, Shealy ER, Wetzel M, Feldman SR (December 2017). "A Review of the Use of Secukinumab for Psoriatic Arthritis". Rheumatology and Therapy. 4 (2): 233–246. doi:10.1007/s40744-017-0076-0. PMC 5696288. PMID 28849401.
  8. ^ "FDA Approves Intravenous Variant of Secukinumab for Psoriatic Arthritis, Other Arthritis Types". HCP Live. 6 October 2023. Retrieved 9 October 2023.
  9. ^ Kim PJ, Lansang RP, Vender R (July 2023). "A Systematic Review and Meta-Analysis of Injection Site Reactions in Randomized-Controlled Trials of Biologic Injections". Journal of Cutaneous Medicine and Surgery. 27 (4): 358–367. doi:10.1177/12034754231188444. PMC 10486173. PMID 37533141.
  10. ^ Marwaha AK, Leung NJ, McMurchy AN, Levings MK (2012). "TH17 Cells in Autoimmunity and Immunodeficiency: Protective or Pathogenic?". Frontiers in Immunology. 3: 129. doi:10.3389/fimmu.2012.00129. PMC 3366440. PMID 22675324.
  11. ^ a b Lubrano E, Perrotta FM (2016). "Secukinumab for ankylosing spondylitis and psoriatic arthritis". Therapeutics and Clinical Risk Management. 12: 1587–1592. doi:10.2147/TCRM.S100091. PMC 5085310. PMID 27799780.
  12. ^ a b Shirley M, Scott LJ (July 2016). "Secukinumab: A Review in Psoriatic Arthritis". Drugs. 76 (11): 1135–1145. doi:10.1007/s40265-016-0602-3. PMID 27299434. S2CID 24638664.
  13. ^ Nelson AL, Dhimolea E, Reichert JM (October 2010). "Development trends for human monoclonal antibody therapeutics". Nature Reviews. Drug Discovery. 9 (10): 767–774. doi:10.1038/nrd3229. PMID 20811384. S2CID 594719.
  14. ^ Hueber W, Patel DD, Dryja T, Wright AM, Koroleva I, Bruin G, et al. (October 2010). "Effects of AIN457, a fully human antibody to interleukin-17A, on psoriasis, rheumatoid arthritis, and uveitis". Science Translational Medicine. 2 (52): 52ra72. doi:10.1126/scitranslmed.3001107. PMID 20926833. S2CID 10132276.
  15. ^ "Novartis Snags Remaining 23% Stake in Alcon with $12.9B Cash and Share Deal". Genetic Engineering News. 15 December 2010.
  16. ^ Di Padova FE, Gram H, Hofstetter H, Jeschke M, Rondeau JM, Van Den Berg W (2010). "US 7807155: IL-17 antagonistic antibodies".
  17. ^ "Drug Approval Package: Cosentyx (secukinumab) NDA #125504". U.S. Food and Drug Administration (FDA). 24 December 1999. Retrieved 7 May 2020.
  18. ^ "FDA approves new psoriasis drug Cosentyx" (Press release). U.S. Food and Drug Administration (FDA). 21 January 2015. Archived from the original on 22 January 2015. Retrieved 21 January 2015.
  19. ^ "Novartis receives two new FDA approvals for Cosentyx to treat patients with ankylosing spondylitis and psoriatic arthritis in the US" (Press release). Novartis. 15 January 2016.
  20. ^ "FDA Approves Label Update for Secukinumab". MD Magazine. Retrieved 27 June 2018.
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