Formulary
Secukinumab: Indications, Dosing, Side Effects and Interactions
Secukinumab is a recombinant human monoclonal antibody that selectively binds to cytokine interleukin-17A (IL-17A) and inhibits the release of proinflammatory...
MedNext Academy | 4 min read
Secukinumab: Indications, Dosing, Side Effects and Interactions
Secukinumab is a recombinant human monoclonal antibody that selectively binds to cytokine interleukin-17A (IL-17A) and inhibits the release of proinflammatory...
Drug action
Secukinumab is a recombinant human monoclonal antibody that selectively binds to cytokine interleukin-17A (IL-17A) and inhibits the release of proinflammatory cytokines and chemokines.
Indications and dose
**Ankylosing spondylitis (under expert supervision)**
- **Adult** (By Subcutaneous Injection): 150 mg every week for 5 doses, then maintenance 150 mg every month, dose may be increased to 300 mg according to clinical response. Review treatment if no response within 16 weeks of initial dose.
**Non-radiographic axial spondyloarthritis (under expert supervision)**
- **Adult** (By Subcutaneous Injection): 150 mg every week for 5 doses, then maintenance 150 mg every month, review treatment if no response within 16 weeks of initial dose.
**Psoriatic arthritis (under expert supervision)**
- **Adult** (By Subcutaneous Injection): 150 mg every week for 5 doses, then maintenance 150 mg every month, dose may be increased to 300 mg according to clinical response. Review treatment if no response within 16 weeks of initial dose.
**Psoriatic arthritis [with concomitant moderate to severe plaque psoriasis] (under expert supervision)**
- **Adult** (By Subcutaneous Injection): (body-weight 90 kg and above) 300 mg every week for 5 doses, then maintenance 300 mg every month, review treatment if no response within 16 weeks of initial dose; increased if necessary to 300 mg every 2 weeks, review treatment if no response within 16 weeks of initial dose.
**Psoriatic arthritis [if inadequate response to anti-TNF treatment] (under expert supervision)**
- **Adult** (By Subcutaneous Injection): 300 mg every week for 5 doses, then maintenance 300 mg every month, review treatment if no response within 16 weeks of initial dose.
**Plaque psoriasis (under expert supervision)**
- **Adult** (By Subcutaneous Injection): (body-weight 90 kg and above) 300 mg every week for 5 doses, then maintenance 300 mg every month, review treatment if no response within 16 weeks of initial dose; increased if necessary to 300 mg every 2 weeks, review treatment if no response within 16 weeks of initial dose.
**Hidradenitis suppurativa (under expert supervision)**
- **Adult** (By Subcutaneous Injection): 300 mg every week for 5 doses, then maintenance 300 mg every month, review treatment if no response within 16 weeks of initial dose; increased if necessary to 300 mg every 2 weeks, review treatment if no response within 16 weeks of initial dose.
**Plaque psoriasis (under expert supervision) for secukinumab**
- **Child 6-17 years (body-weight up to 50 kg)** (By subcutaneous injection): 75 mg every week for 5 doses, then maintenance 75 mg every month, review treatment if no response within 16 weeks of initial dose.
- **Child 6-17 years (body-weight 50 kg and above)** (By subcutaneous injection): 150 mg every week for 5 doses, then maintenance 150 mg every month, dose may be increased to 300 mg according to clinical response. Review treatment if no response within 16 weeks of initial dose.
**Enthesitis-related arthritis (under expert supervision), Juvenile psoriatic arthritis (under expert supervision) for secukinumab**
- **Child 6-17 years (body-weight up to 50 kg)** (By subcutaneous injection): 75 mg every week for 5 doses, then maintenance 75 mg every month, review treatment if no response within 16 weeks of initial dose.
- **Child 6-17 years (body-weight 50 kg and above)** (By subcutaneous injection): 150 mg every week for 5 doses, then maintenance 150 mg every month, review treatment if no response within 16 weeks of initial dose.
Cautions
Chronic infection; history of recurrent infection; inflammatory bowel disease (discontinue if signs or symptoms develop, or an exacerbation occurs); predisposition to infection (discontinue if new serious infection develops) Cautions, further information Tuberculosis Anti-tuberculosis therapy should be considered before starting secukinumab in patients with latent tuberculosis. M
Contraindications
Severe active infection
Side effects
Common or very common Diarrhoea; fatigue; headache; increased risk of infection; nausea; rhinorrhoea Uncommon Conjunctivitis; inflammatory bowel disease; neutropenia (usually mild and reversible); skin reactions Rare or very rare Anaphylactic reaction; hypersensitivity vasculitis Frequency not known Pyoderma gangrenosum
Interactions
**Other interactions (3):**
- Live vaccines should not be given concurrently with secukinumab (see also section 4.4).
- In a study in adult subjects with plaque psoriasis, no interaction was observed between secukinumab and midazolam (CYP3A4 substrate).
- No interaction was seen when secukinumab was administered concomitantly with methotrexate (MTX) and/or corticosteroids in arthritis studies (including in patients with psoriatic arthritis and axial...
Pregnancy
Manufacturer advises avoid-no information available.
Breast feeding
Manufacturer advises avoid during treatment and for up to 20 weeks after discontinuing treatment-no information available.
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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