Secukinumab
Indications
Secukinumab is used for:
Indicated for, moderate-to-severe plaque psoriasis, in patients who are candidates for systemic therapy or phototherapy, indication includes, treatment for moderate-to-severe scalp psoriasis, active psoriatic arthritis, active ankylosing spondylitis
Adult Dose
Subcutaneous
Plaque psoriasis
Adult: 300 mg every week for 5 doses, followed by 300 mg every month. Each 300 mg dose is given as 2 injections of 150 mg. Review treatment if no response within 16 weeks of initial dose.
Psoriatic arthritis
Adult: 150 mg every week for 5 doses, followed by 150 mg every month, may increase to 300 mg if response is inadequate. Coexistent moderate to severe plaque psoriasis or anti-TNF? inadequate responders: 300 mg every week for 5 doses, followed by 300 mg every month. Review treatment if there is no response after 16 weeks.
Ankylosing spondylitis
Adult: 150 mg once weekly for 5 weeks, then once monthly thereafter. Review treatment if there is no response after 16 weeks.
Child Dose
Renal Dose
Administration
Powd for inj: Reconstitute 150 mg vial w/ 1 mL sterile water for inj to make a 150 mg/mL soln.
Contra Indications
Serious infections (e.g. active TB, hepatitis B, sepsis). Admin of live vaccines.
Precautions
Patient w/ history of recurrent or chronic infection, inflammatory bowel disease (e.g. Crohn’s disease). Pregnancy and lactation.
Pregnancy-Lactation
Pregnancy Category: B
Lactation: Unknown if distributed in human breast milk
Interactions
May enhance the adverse effects and diminish the therapeutic effect of live vaccines.
Adverse Effects
Side effects of Secukinumab :
>10%
Infections (28.7%)
Nasopharyngitis (11.4-12.3%)
1-10%
Diarrhea (2.6-4.1%)
URT infection (2.5-3.2%)
Rhinitis (1.4%)
Oral herpes (0.1-1.3%)
Pharyngitis (1-1.2%)
Urticaria (0.6-1.2%)
Rhinorrhea (0.3-1.2%)
Mechanism of Action
Secukinumab is a recombinant fully human IgG1/K monoclonal antibody that selectively binds to interleukin-17A (IL-17A), a cytokine involved in normal inflammatory and immune responses, thus inhibiting the release of proinflammatory cytokines, chemokines, and mediators of tissue damage.