Secukinumab

Secukinumab is used to treat psoriasis, ankylosing spondylitis, and psoriatic arthritis.{{cite journal | vauthors = Patel NU, Vera NC, Shealy ER, Wetzel M, Feldman SR | title = A Review of the Use of Secukinumab for Psoriatic Arthritis | journal = Rheumatology and Therapy | volume = 4 | issue = 2 | pages = 233–246 | date = December 2017 | pmid = 28849401 | pmc = 5696288 | doi = 10.1007/s40744-017-0076-0 }} 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. In October 2023, the FDA approved an intravenous variant of secukinumab.{{cite web |date=6 October 2023 |title=FDA Approves Intravenous Variant of Secukinumab for Psoriatic Arthritis, Other Arthritis Types |url=https://www.hcplive.com/view/fda-approves-intravenous-variant-secukinumab-psoriatic-arthritis-other-arthritis-types |access-date=9 October 2023 |website=HCP Live |language=en}}

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; the European Medicines Agency (EMA) advises that women should not become pregnant while taking it.

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

• moderate to severe plaque psoriasis in adults, children and adolescents from the age of six years who are candidates for systemic therapy.
• 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.
• active ankylosing spondylitis in adults who have responded inadequately to conventional therapy.
• 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).
• active moderate to severe hidradenitis suppurativa in adults with an inadequate response to conventional systemic HS therapy.
• active enthesitis-related arthritis in patients 6 years and older whose disease has responded inadequately to, or who cannot tolerate, conventional therapy.
• active juvenile psoriatic arthritis in patients 6 years and older whose disease has responded inadequately to, or who cannot tolerate, conventional therapy.

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

Common (between 1% and 10% of people experience them) include oral herpes, runny nose, and diarrhea. Injection site reactions are common, occurring in approximately 1.9% of cases.{{cite journal | vauthors = Kim PJ, Lansang RP, Vender R | title = A Systematic Review and Meta-Analysis of Injection Site Reactions in Randomized-Controlled Trials of Biologic Injections | journal = Journal of Cutaneous Medicine and Surgery | volume = 27 | issue = 4 | pages = 358–367 | date = July 2023 | pmid = 37533141 | doi = 10.1177/12034754231188444 | pmc = 10486173 | doi-access = free }}

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. 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.{{cite journal | vauthors = Marwaha AK, Leung NJ, McMurchy AN, Levings MK | title = TH17 Cells in Autoimmunity and Immunodeficiency: Protective or Pathogenic? | journal = Frontiers in Immunology | volume = 3 | issue = | pages = 129 | date = 2012 | pmid = 22675324 | pmc = 3366440 | doi = 10.3389/fimmu.2012.00129 | doi-access = free }}

Secukinumab inhibits a member of the cytokine family, interleukin 17A, which is produced mainly by inflammatory T helper 17 cells.{{cite journal | vauthors = Lubrano E, Perrotta FM | title = Secukinumab for ankylosing spondylitis and psoriatic arthritis | journal = Therapeutics and Clinical Risk Management | volume = 12 | pages = 1587–1592 | date = 2016 | pmid = 27799780 | pmc = 5085310 | doi = 10.2147/TCRM.S100091 | doi-access = free }} 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.{{cite journal | vauthors = Shirley M, Scott LJ | title = Secukinumab: A Review in Psoriatic Arthritis | journal = Drugs | volume = 76 | issue = 11 | pages = 1135–1145 | date = July 2016 | pmid = 27299434 | doi = 10.1007/s40265-016-0602-3 | s2cid = 24638664 }}

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

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

Secukinumab was discovered and developed by Novartis using developmental name AIN457, and the first publication was a Phase I trial published in 2010.{{cite journal | vauthors = Nelson AL, Dhimolea E, Reichert JM | title = Development trends for human monoclonal antibody therapeutics | journal = Nature Reviews. Drug Discovery | volume = 9 | issue = 10 | pages = 767–774 | date = October 2010 | pmid = 20811384 | doi = 10.1038/nrd3229 | s2cid = 594719 }}{{cite journal | vauthors = Hueber W, Patel DD, Dryja T, Wright AM, Koroleva I, Bruin G, Antoni C, Draelos Z, Gold MH, Durez P, Tak PP, Gomez-Reino JJ, Foster CS, Kim RY, Samson CM, Falk NS, Chu DS, Callanan D, Nguyen QD, Rose K, Haider A, Di Padova F | title = Effects of AIN457, a fully human antibody to interleukin-17A, on psoriasis, rheumatoid arthritis, and uveitis | journal = Science Translational Medicine | volume = 2 | issue = 52 | pages = 52ra72 | date = October 2010 | pmid = 20926833 | doi = 10.1126/scitranslmed.3001107 | s2cid = 10132276 | doi-access = }}{{cite news|title=Novartis Snags Remaining 23% Stake in Alcon with $12.9B Cash and Share Deal|url=http://www.genengnews.com/gen-news-highlights/novartis-snags-remaining-23-stake-in-alcon-with-12-9b-cash-and-share-deal/81244384|work=Genetic Engineering News|date=15 December 2010|access-date=2 October 2017|archive-date=3 October 2017|archive-url=https://web.archive.org/web/20171003030338/http://www.genengnews.com/gen-news-highlights/novartis-snags-remaining-23-stake-in-alcon-with-12-9b-cash-and-share-deal/81244384|url-status=live}}{{cite web|vauthors=Di Padova FE, Gram H, Hofstetter H, Jeschke M, Rondeau JM, Van Den Berg W|title=US 7807155: IL-17 antagonistic antibodies|url=https://patents.google.com/patent/US7807155|date=2010|access-date=8 June 2024|archive-date=17 August 2024|archive-url=https://web.archive.org/web/20240817043846/https://patents.google.com/patent/US7807155|url-status=live}}

In January 2015, secukinumab was approved in the United States and in the European Union to treat adults with moderate-to-severe plaque psoriasis.{{cite web | title=Drug Approval Package: Cosentyx (secukinumab) NDA #125504 | website=U.S. Food and Drug Administration (FDA) | date=24 December 1999 | url=https://www.accessdata.fda.gov/drugsatfda_docs/nda/2015/125504Orig1s000TOC.cfm | access-date=7 May 2020 | archive-date=3 April 2021 | archive-url=https://web.archive.org/web/20210403020156/https://www.accessdata.fda.gov/drugsatfda_docs/nda/2015/125504Orig1s000TOC.cfm | url-status=live }}{{cite press release| url=https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm430969.htm| archive-url=https://web.archive.org/web/20150122001418/http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm430969.htm| url-status=dead| archive-date=22 January 2015| title=FDA approves new psoriasis drug Cosentyx| date=21 January 2015| publisher=U.S. Food and Drug Administration (FDA) | access-date=21 January 2015}}{{cite web | title=Cosentyx EPAR | website=European Medicines Agency (EMA) | date=17 September 2018 | url=https://www.ema.europa.eu/en/medicines/human/EPAR/cosentyx | access-date=7 May 2020 | archive-date=22 August 2020 | archive-url=https://web.archive.org/web/20200822051102/https://www.ema.europa.eu/en/medicines/human/EPAR/cosentyx | url-status=live }} Text was copied from this source which is copyright European Medicines Agency. Reproduction is authorized provided the source is acknowledged. It is the first IL17A inhibiting drug ever approved. 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.{{cite press release |url=https://www.novartis.com/news/media-releases/novartis-receives-two-new-fda-approvals-cosentyx-treat-patients-ankylosing-spondylitis-and-psoriatic-arthritis-us |title=Novartis receives two new FDA approvals for Cosentyx to treat patients with ankylosing spondylitis and psoriatic arthritis in the US |date=15 January 2016 |publisher=Novartis |access-date=8 May 2020 |archive-date=8 May 2020 |archive-url=https://web.archive.org/web/20200508043159/https://www.novartis.com/news/media-releases/novartis-receives-two-new-fda-approvals-cosentyx-treat-patients-ankylosing-spondylitis-and-psoriatic-arthritis-us |url-status=live }}{{cite web|url=http://www.mdmag.com/medical-news/fda-approves-label-update-for-secukinumab|title=FDA Approves Label Update for Secukinumab|website=MD Magazine|access-date=27 June 2018|archive-date=27 June 2018|archive-url=https://web.archive.org/web/20180627175130/http://www.mdmag.com/medical-news/fda-approves-label-update-for-secukinumab|url-status=live}}

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Category:Immunosuppressants

Category:Drugs developed by Novartis

Category:Monoclonal antibodies

Category:Disease-modifying antirheumatic drugs