Cosentyx: a new option in plaque psoriasis

Novartis has launched Cosentyx (secukinumab), the first biologic licensed for first-line treatment of moderate to severe plaque psoriasis.

Psoriasis is a chronic autoimmune disease characterised by thick and extensive skin lesions (plaques) | SCIENCE PHOTO LIBRARY
Psoriasis is a chronic autoimmune disease characterised by thick and extensive skin lesions (plaques) | SCIENCE PHOTO LIBRARY

First IL-17A inhibitor

Secukinumab is a monoclonal antibody that selectively binds to and neutralises interleukin-17A (IL-17A), a protein involved in the development of psoriasis and found in significantly higher concentrations in psoriasis-affected skin. This inhibits the release of proinflammatory cytokines, chemokines and mediators of tissue damage and reduces IL-17A-mediated contributions to autoimmune and inflammatory diseases.

CLINICAL STUDIES

Further information
View Cosentyx drug record 
Summary of Product Characteristics
Manufacturer: Novartis

The safety and efficacy of secukinumab in patients with moderate to severe plaque psoriasis were assessed in four randomised, double-blind, phase III trials. Participants were candidates for phototherapy or systemic therapy.

In the 52-week ERASURE (n=738) and FIXTURE (n=1306) studies, patients received subcutaneous secukinumab 300mg or 150mg (administered once weekly for 5 weeks, then every 4 weeks), etanercept 50mg (FIXTURE study only; administered twice weekly until week 12 then once weekly) or placebo.

At week 12, the proportion of patients who achieved a ≥75% improvement in Psoriasis Area and Severity Index (PASI 75) was significantly higher with secukinumab than with placebo or etanercept (ERASURE, 81.6% with secukinumab 300mg vs 4.5% with placebo; FIXTURE, 77.1% with secukinumab 300mg vs 44.0% with etanercept and 4.9% with placebo; p<0.001 for all). 

The proportion of patients with a response of 0 or 1 on the modified investigator's global assessment at week 12 was also higher with secukinumab than with placebo or etanercept (ERASURE, 65.3% with secukinumab 300mg vs 2.4% with placebo; FIXTURE, 62.5% with secukinumab 300mg vs 27.2% with etanercept and 2.8% with placebo; p<0.001 for all).

Continued treatment past week 12 was associated with sustained high response rates in most patients at week 52.

Self-administration

The FEATURE (n=177) and JUNCTURE (n=182) studies evaluated the safety, tolerability and usability of secukinumab self-administration. Participants were randomised to receive secukinumab 150mg or 300mg or placebo.

In both trials significantly more patients receiving secukinumab at either dose achieved PASI 75 at week 12 than did those receiving placebo (p<0.0001). Patient-reported acceptability of self-administration was high throughout both studies.

Safety profile

The most commonly reported adverse effects of secukinumab were upper respiratory tract infections including nasopharyngitis and rhinitis.


MIMS Clinics

Prescribing news and resources for key therapeutic areas, collated by the MIMS editors.

Register or Subscribe to MIMS

GPs can get MIMS print & online and GPonline for free when they register online – take 2 minutes, and make sure you get your free MIMS access! If you're not a GP, you can subscribe to MIMS for full access.

Register or subscribe

MIMS bulletins

News and updates straight to your inbox.

Prescribing Update: Fortnightly news bulletin
Alert:
Urgent prescribing updates
Spotlight: Disease-themed monthly round-up

Sign me up

MIMS Dermatology

Read the latest issue online exclusively on MIMS Learning.

Read MIMS Dermatology

Mobile apps

MIMS: access the full drug database and quick-reference tables on the go

MIMS Diagnosis and Management: concise information on signs and symptoms, investigations and diseases

Promo Image

Clinical calculators

Handy calculators and conversions for primary care.