Cimzia vs. Cosentyx: 5 Differences You Should Know for Nr-axSpA
Key takeaways:
Cimzia (certolizumab pegol) and Cosentyx (secukinumab) are biologic medications that treat non-radiographic axial spondyloarthritis (nr-axSpA). Both are available as under-the-skin injection pens, but Cosentyx is also available as an intravenous (IV) infusion.
Cimizia may be more effective than Cosentyx at improving nr-axSpA symptoms. But it carries a boxed warning about potentially serious infections and a risk of cancer.
Cimzia and Cosentyx work in different ways, and they’re not interchangeable. Your healthcare provider may consider switching you from one to the other if you experience bothersome side effects or your symptoms aren’t well controlled.
There are ways to save on Cimzia and Cosentyx. If you’re eligible, manufacturer savings cards can help make your prescription more affordable. Patient assistance programs are also available.
Table of contents
Non-radiographic axial spondyloarthritis (nr-axSpA) is a form of arthritis that mostly affects the spine and pelvic joints. But unlike other types of arthritis, nr-axSpA doesn't show visible damage to your bones on an X-ray. This can make nr-axSpA a bit trickier than normal to diagnose.
If nr-axSpA progresses, it can become ankylosing spondylitis. This can be seen on an X-ray. Once nr-AxSpA is diagnosed, there are several treatment options available to ease your symptoms.
Cimzia (certolizumab pegol) and Cosentyx (secukinumab) are two such treatment options. They’re both injectable medications, but they have some key differences. Here, we’ll discuss how Cimzia and Cosentyx compare for nr-axSpA.
An interchangeable biosimilar to Humira® for 92% less
Introducing Adalimumab-adbm, an autoimmune medication that is the first-ever FDA-approved interchangeable biosimilar to Humira®. Get it for 92% less than the Humira® list price.
1. Cimzia and Cosentyx each work in their own way
Nr-axSpA is an autoimmune disorder that prompts your immune system to mistakenly attack your healthy body tissue. This can lead to inflammation and bothersome symptoms you may be experiencing, such as lower back pain and stiffness. Cimzia and Cosentyx are biologic medications (made from living sources) that help calm an overactive immune system to lessen inflammation and the symptoms that go along with it.
Cimzia and Cosentyx do this by targeting a group of immune proteins called cytokines. Cytokines are chemical messengers that communicate pain and inflammation signals throughout your body. But each medicine targets a different type of cytokine.
Cimzia is a tumor necrosis factor (TNF) blocker. TNF is a cytokine made by immune cells called macrophages, and too much of it can lead to chronic inflammation. Cimzia works by blocking TNF to lower the amount of inflammation you have.
Cosentyx, on the other hand, is an interleukin-17A (IL-17A) blocker. IL-17A is a cytokine made by various types of immune cells. Similar to TNF, IL-17A levels are typically higher in people with nr-axSpA. Cosentyx stops IL-17A from causing excessive inflammation.
2. Cosentyx is available as an injection and infusion
Both Cimzia and Cosentyx are available as at-home injection pens. They’re injected subcutaneously (just beneath the skin) using a short needle. Each medication slowly enters your bloodstream from your skin.
Although this is convenient, giving yourself injections can be intimidating. As of October 2023, Cosentyx is also available as an intravenous (IV) infusion. If you aren’t comfortable with the idea of giving yourself injections, you now have the option to head to your healthcare provider’s office for a relatively quick infusion.
Each Cosentyx infusion takes about 30 minutes to complete. After your first infusion, your healthcare provider will likely monitor you for at least an hour in case of any side effects.
Good to know: The IV dosage of Cosentyx is based on your body weight. Weight-based doses offer a more personalized treatment regimen than fixed-dose medications.
3. Cimzia and Cosentyx have different dosages
Cimzia and Cosentyx each usually start with loading doses (starting doses). These doses help the medications reach an effective level in your body more quickly. But this is where the similarities end.
The starting and maintenance dosages of Cimzia and Cosentyx for nr-axSpA are detailed in the table below.
Medication | Loading dosage | Maintenance dosage |
Cimzia | 400 mg subcutaneously every 2 weeks for 3 doses | 200 mg subcutaneously every 2 weeks, or 400 mg subcutaneously every 4 weeks |
Cosentyx | 150 mg subcutaneously every week for 5 doses, or 6 mg/kg IV for 1 dose | 150 mg subcutaneously every 4 weeks, or 1.75 mg/kg (up to 300 mg) IV every 4 weeks |
4. Some studies suggest Cimzia is more effective than Cosentyx
Cimzia and Cosentyx haven’t been directly compared in head-to-head studies. This would be the main way to tell if one is better than the other. But a systematic review of multiple clinical trials suggests that Cimzia is more effective than Cosentyx at improving nr-axSpA symptoms and preventing it from getting worse.
The studies measured a set of criteria called the ASAS40. This standardized criteria, developed by the Assessment of Spondyloarthritis international Society (ASAS), is used to determine how effective medications are in treating spondyloarthritis. The ASAS40 measures changes in pain, inflammation, mobility, and quality of life. People who achieved ASAS40 showed at least a 40% improvement in three of these four areas.
Compared to Cosentyx, Cimzia had a significantly higher ASAS40 response rate. What’s more, Cimzia had a significantly higher percentage of people who experienced remission after 16 weeks (about 4 months) of treatment. Remission is when your symptoms almost or completely disappear.
However, keep in mind that everyone responds to autoimmune medications differently. The best medication for you may not be the best medication for someone else.
5. Cimzia and Cosentyx have different risks and side effects
Biologic medications that treat autoimmune disorders can raise your risk of infections since they intentionally interfere with your immune system. This is the most common side effect people tend to experience while receiving Cimzia or Cosentyx. Infections, such as upper respiratory tract infections and urinary tract infections, have been reported.
Other common Cimzia side effects include:
Headache
Elevated blood pressure
Back pain
Skin rashes
Runny nose
Sore throat
Common Cosentyx side effects include:
Diarrhea
Stomach pain
Cold sores
Hives
Runny nose
Sore throat
Cimzia has a boxed warning
Because Cimzia is a TNF blocker, it carries a boxed warning of rare but life-threatening infections and cancer. A boxed warning is the strictest warning the FDA can give a medication. All TNF inhibitors carry this warning.
As mentioned earlier, TNF blockers interfere with one of your immune system’s first lines of defense. This can potentially lead to conditions like:
Chronic or recurring infections
Fungal infections
Sepsis (extreme immune response to an infection)
Lymphoma and other cancers
If you’re prescribed Cimzia and experience any signs or symptoms of infection — or any unexplained changes in your body — let your healthcare provider know right away.
Can you switch from Cimzia to Cosentyx, or vice versa?
Yes, it’s possible to switch between Cimzia and Cosentyx. But they aren’t considered interchangeable.
In fact, many people switch between biologics over the course of their treatment. Some medications can grow less effective over time. Or it’s possible the symptoms that you’re experiencing may gradually evolve and would respond better to a different treatment. In cases like these, switching medications could result in a better response.
If your healthcare provider determines that you need a change in therapy, they will work with you to safely make the switch. They will carefully schedule your transition between biologics to lower your risk of having bothersome side effects or a flare up in your symptoms.
How to save on Cimzia and Cosentyx
Cimzia and Cosentyx are only available as reference (“brand-name”) medications. But GoodRx can help you navigate ways to save on your prescription.
Save with a copay savings card. If you have commercial insurance and meet eligibility requirements, Cimzia’s price is as little as $0 per dose if you use the manufacturer’s savings card. Cosentyx’s price is also as little as $0 per dose if you use the manufacturer’s savings card.
Save with patient assistance programs. If you’re uninsured or underinsured, you may be eligible for the Cimzia or Cosentyx patient assistance programs, which offer the medications at no charge.
As an added bonus, both medications have “bridge” programs that offer free medication while you’re waiting for your health insurance to approve your prescription.
The bottom line
Cimzia (certolizumab pegol) and Cosentyx (secukinumab) are injectable medications that are FDA approved to treat non-radiographic axial spondyloarthritis (nr-axSpA). While both are biologic medications, they differ in how they work, their recommended dosages, and their potential side effects. Cimizia may be more effective than Cosentyx at improving nr-axSpA symptoms, but it may have more risks. Your healthcare provider may switch you from one to the other when needed.
Why trust our experts?
References
Akkoç, N., et al. (2023). Comparative efficacy of biologic disease-modifying anti-rheumatic drugs for non-radiographic axial spondyloarthritis: A systematic literature review and Bucher indirect comparisons. Rheumatology and Therapy.
Landewé, R., et al. (2015). Clinical tools to assess and monitor spondyloarthritis. Current Rheumatology Reports.
Novartis Pharmaceuticals Corporation. (2023). Cosentyx [package insert].
Novartis Pharmaceuticals Corporation. (2023). FDA approves novartis cosentyx® as first intravenous (IV) formulation interleukin-17A antagonist for rheumatic diseases.
Stavem, K. (2021). Switching from one reference biological to another in stable patients for non-medical reasons: A literature search and brief review. Journal of Market Access and Health Policy.
UCB, Inc. (2023). Cimzia [package insert].
Zwicky, P., et al. (2020). Targeting interleukin-17 in chronic inflammatory disease: A clinical perspective. The Journal of Experimental Medicine.
