bDMARDs Quick Reference Guide

Secukinumab

Secukinumab

HomeMonographsSecukinumab

Active ingredient

Secukinumab

Mechanism of action

Interleukin (IL) -17A inhibitor

Molecule type

IgG monoclonal antibody (human)

PBS listed indications

RheumatologyAxial spondyloarthritis

  • Ankylosing spondylitis
  • Non-radiographic axial spondyloarthritis

Severe psoriatic arthritis

DermatologySevere chronic plaque psoriasis

Reference product (brand)

Cosentyx

Biosimilar brands

None

Administration information

Mode of administration

Subcutaneous injection

Administration devices and strengths

Pre-filled pen (autoinjector) 150mg/mL

Instructions for patient self-administration are outlined in the CMI.

Frequency of administration

Every 4 weeks (maintenance)

Storage

Store at 2-8oC (refrigerate do no freeze).

Keep the pre-filled pens in the outer carton until time of use to protect from light.

May be stored unrefrigerated for a single period up to a maximum of 4 days at room temperature below 30oC. Do not return the product to the refrigerator after it has reached room temperature.

For a more comfortable injection, patients may remove the carton from the refrigerator before injecting and allow to reach room temperature (20 minutes) without removing the needle cap during this time.

Standard dosing

Ankylosing spondylitis: 150mg once a week for 5 weeks (weeks 0, 1, 2, 3, 4) then once every 4 weeks.

Non-radiographic axial spondyloarthritis: 

With a loading dose - 150mg once a week for 5 weeks (weeks 0, 1, 2, 3, 4), then once every 4 weeks.

Without a loading dose - 150mg once every 4 weeks.

 

Psoriatic arthritis: 150mg once a week for 5 weeks (weeks 0, 1, 2, 3, 4), then once every 4 weeks

 

Plaque psoriasis: 300mg (2 x 150mg injections) once a weeks for 5 weeks (weeks 0, 1, 2, 3, 4), then once every 4 weeks.

The two 150mg injections should be injected at separate sites.

 

Treatment with csDMARDs (e.g., methotrexate) may be continued during treatment with secukinumab. 

Dose variations

Ankylosing spondylitis and psoriatic arthritis: Dose may be increased to 300mg every 4 weeks if response is inadequate.

This dosing may be outside PBS funding. Specialist prescribers may arrange supply through alternate pathways.  

Special notes

Secukinumab has the potential to reactivate latent TB (begin TB treatment before starting).
Patients with suspected latent or active TB should be treated in consultation with an Infectious Diseases physician.

Secukinumab may increase the risk of infection. Treatment should not be initiated in patients with clinically significant active infection until the infection resolves or is adequately treated.

 

New cases and exacerbations of Crohn disease and ulcerative colitis have occurred in patients being treated with secukinumab.
Patients treated with secukinumab should be monitored for signs and symptoms of inflammatory bowel disease.

 

Live vaccines should not be given concurrently with secukinumab.

References

Pharmaceutical benefits Scheme (PBS) listing. Available from https://www.pbs.gov.au/medicine/item/10425Q-10494H-10890E-10893H-10894J-10895K-10898N-10899P-10900Q-10901R-10906B-10910F-12297F-12307R-12321L [accessed 8/10/21]

Product information. Available from https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2015-PI-01060-1 [accessed 8/10/21]

Australian Medicines Handbook 2020 (online). Adelaide: Australian Medicines Handbook Pty Ltd; 2020 July. Available from: https://amhonline.amh.net.au/