Secukinumab
Indications
Secukinumab is used for:
Moderate-to-severe plaque psoriasis, moderate-to-severe scalp psoriasis, active psoriatic arthritis, active ankylosing spondylitis, Non-radiographic Axial Spondyloarthritis
Adult Dose
Adult:
Subcutaneous
Plaque psoriasis
Indicated for treatment of moderate to severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy
Adult: 300 mg in 2 divided doses at weeks 0, 1, 2, 3, and 4, followed by 300 mg monthly maintenance dosing.
Review treatment if no response within 16 weeks of initial dose.
Psoriatic arthritis
Indicated for active psoriatic arthritis (PsA) in adults
For PsA patients with coexistent moderate to severe plaque psoriasis, use dosage and administration for plaque psoriasis.
With loading dose: 150 mg SC at weeks 0, 1, 2, 3, and 4 and monthly thereafter.
Without a loading dose: 150 mg SC every month.
Review treatment if there is no response after 16 weeks.
Ankylosing spondylitis
Indicated for adults with active ankylosing spondylitis
Administer with or without a loading dosage by SC injection
With loading dose: 150 mg SC at weeks 0, 1, 2, 3, and 4 and monthly thereafter
Without a loading dose: 150 mg SC every month
If a patient continues to have active ankylosing spondylitis, consider increasing dose to 300 mg every month
Review treatment if there is no response after 16 weeks.
Non-radiographic Axial Spondyloarthritis
Indicated for active non-radiographic axial spondylarthritis with objective signs of inflammation
Administer with or without loading dose
With loading dose: 150 mg SC at Weeks 0, 1, 2, 3, and 4, THEN monthly thereafter
Without loading dose: 150 mg SC every month
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
Limited available human data regarding use in pregnant women are insufficient to inform a drug associated risk of adverse developmental outcomes
Animal data
No adverse developmental effects were observed in infants born to pregnant monkeys after SC administration of secukinumab during organogenesis at doses up to 30 times the maximum recommended human dose (MRHD)
Lactation
Unknown if excreted in human milk or absorbed systemically after ingestion; data are unavailable regarding effects on breastfed children or milk production
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.