Cosentyx® (secukinumab): Real-world experience with flexible dosing in eligible patients

Cosentyx is indicated for the treatment of moderate to severe plaque psoriasis (PsO) in adults, children and adolescents from the age of 6 years who are candidates for systemic therapy; active psoriatic arthritis (PsA) in adult patients (alone or in combination with methotrexate [MTX]) when the response to previous disease-modifying anti-rheumatic drug therapy has been inadequate; active ankylosing spondylitis (AS) in adults who have responded inadequately to conventional therapy; active nonradiographic axial spondyloarthritis (nr-axSpA) with objective signs of inflammation as indicated by elevated C-reactive protein and/or magnetic resonance imaging evidence in adults who have responded inadequately to non-steroidal anti-inflammatory drugs; active moderate to severe hidradenitis suppurativa (HS; acne inversa) in adults with an inadequate response to conventional systemic HS therapy; active enthesitis-related arthritis (ERA) in patients 6 years and older (alone or in combination with MTX) whose disease has responded inadequately to, or who cannot tolerate, conventional therapy; active juvenile psoriatic arthritis (JPsA) in patients 6 years and older (alone or in combination with MTX) whose disease has responded inadequately to, or who cannot tolerate, conventional therapy.¹

For full indications, please refer to the Cosentyx Summary of Product Characteristics (SmPC).

Cosentyx has not been studied in patients with renal/hepatic impairment. No dose recommendations can be made.¹

Cosentyx offers flexible dosing in eligible patients with PsA and concomitant PsO¹

Eligible patients are those weighing ≥90 kg.

For adults with PsA and concomitant moderate to severe PsO, the recommended dose is 300 mg of Cosentyx by subcutaneous injection with initial dosing at Weeks 0, 1, 2, 3 and 4, followed by monthly maintenance dosing.¹

Based on weight and clinical response, a maintenance dose of 300 mg every 2 weeks may provide additional benefit for adult patients with a body weight ≥90 kg. Each 300 mg dose is given as one subcutaneous injection of 300 mg or as two subcutaneous injections of 150 mg.¹

Hear first-hand experiences of using Cosentyx flexible dosing in eligible patients in the real world

Eligible patients are those weighing ≥90 kg.

Cosentyx 300 mg Q2W dosing may help your eligible patients achieve fast and lasting skin clearance²

Fast = efficacy at 16 weeks and lasting = efficacy at 52 weeks.²

You can tailor the dosing of Cosentyx based on your PsO patients’ clinical response. In the A2324 Q2W clinical trial, FAST (at Week 16) and LASTING skin clearance (at Year 1; exploratory endpoint) was seen in PsA patients with moderate to severe PsO (≥90 kg) treated with Cosentyx 300 mg Q2W vs 300 mg Q4W.²

Adapted from Augustin M, et al. 2022.²

A2324 Q2W was a multicentre, double-blind, parallel-group trial on patients with moderate to severe PsO weighing ≥90 kg (N=331) treated with Cosentyx 300 mg Q2W or Q4W.*²

Primary endpoint of PASI 90 response at Week 16 for Cosentyx 300 mg Q2W vs Q4W was met.²

Safety profile findings are comparable across Cosentyx 300 mg Q2W and Q4W regimes in patients weighing ≥90 kg²

Table adapted from Augustin M, et al. 2022.²

The most frequently reported adverse reactions are upper respiratory tract infections (17.1%) (most frequently nasopharyngitis, rhinitis). Caution should be exercised when considering the use of Cosentyx in patients with a chronic infection or a history of recurrent infection. If a patient develops a serious infection, the patient should be closely monitored and Cosentyx should not be administered until the infection resolves. Patients should be evaluated for tuberculosis infection prior to initiating treatment with Cosentyx. Cosentyx should not be given to patients with active tuberculosis. In patients with latent tuberculosis, anti‑tuberculosis therapy should be considered prior to initiation of Cosentyx. Patients receiving Cosentyx should be monitored for signs and symptoms of active tuberculosis. Cosentyx is not recommended in patients with IBD. If a patient develops signs and symptoms of IBD or experiences an exacerbation of pre-existing inflammatory bowel disease, Cosentyx should be discontinued and appropriate medical management should be initiated.¹

Please refer to the SmPC for full safety information before prescribing. 

Cosentyx is intended for use under the guidance and supervision of a physician experienced in the diagnosis and treatment of conditions for which Cosentyx is indicated.  Please refer to the Cosentyx SmPC for full product information before prescribing.¹

Therapeutic Indications¹
Cosentyx is indicated for the treatment of moderate to severe plaque psoriasis (PsO) in adults, children and adolescents from the age of 6 years who are candidates for systemic therapy; active psoriatic arthritis (PsA) in adult patients (alone or in combination with methotrexate [MTX]) when the response to previous disease-modifying anti-rheumatic drug therapy has been inadequate; active ankylosing spondylitis (AS) in adults who have responded inadequately to conventional therapy; active nonradiographic axial spondyloarthritis (nr-axSpA) with objective signs of inflammation as indicated by elevated C-reactive protein and/or magnetic resonance imaging evidence in adults who have responded inadequately to non-steroidal anti-inflammatory drugs; active moderate to severe hidradenitis suppurativa (HS; acne inversa) in adults with an inadequate response to conventional systemic HS therapy; active enthesitis-related arthritis (ERA) in patients 6 years and older (alone or in combination with MTX) whose disease has responded inadequately to, or who cannot tolerate, conventional therapy; active juvenile psoriatic arthritis (JPsA) in patients 6 years and older (alone or in combination with MTX) whose disease has responded inadequately to, or who cannot tolerate, conventional therapy.¹

*A2324 Q2W: A multicentre, double-blind, parallel group trial of patients weighing  ≥90 kg (N=331) in patients with moderate to severe PsO. Patients received either Cosentyx 300 mg Q2W or Q4W. The primary endpoint was PASI 90 response at Week 16. At Week 16, Q2W led to significantly higher PASI 90 responses vs Q4W (n=166; 73.2% vs 55.5%; p=0.0003). Secondary endpoints were the proportion of patients achieving an IGA mod 2011 score of 0 or 1 (indicating clear or almost clear skin) at Week 16, and clinical safety and tolerability measures (clinical laboratory parameters, vital signs, electrocardiograms and adverse events) up to Week 52.^2
†One patient who did not receive any study treatment after randomisation was excluded from the Q4W safety analyses.^2
‡One death was reported in the Q4W group (patient was aged 83 years with ongoing medical conditions of hyperlipidemia, hypertension and aortic stenosis, and died during Treatment Period 2 of cardiac arrest/acute MI).^2
§Number of patients ≥3 in the overall study population.^2
‖Number of patients ≥10 in the overall study population.²

AE, adverse event; AS, ankylosing spondylitis; ERA, enthesitis-related arthritis; HLT, high-level term; HS, hidradenitis suppurativa; IBD, inflammatory bowel disease; JPsA, juvenile psoriatic arthritis; MACE, major adverse cardiovascular event; MI, myocardial infarction; MTX, methotrexate; NMQ, Novartis MedDRA Query; nr-axSpA, non-radiographic axial spondyloarthritis; PsA, psoriatic arthritis; PsO, plaque psoriasis; Q2W, every 2 weeks; Q4W, every 4 weeks; SAE, serious adverse event; SmPC, summary of product characteristics; SMQ, Standardised MedDRA Query; SOC, system organ class.

References

1. Cosentyx® (secukinumab) Summary of Product Characteristics.

2. Augustin M, et al. Br J Dermatol 2022;186(6):942–954.

UK | January 2026 | FA-11330277-1