What to Know About Cosentyx for Psoriatic Arthritis

Psoriatic arthritis (PsA) is a type of inflammatory arthritis that can develop in people with psoriasis. It can cause severe joint pain and swelling, which can make it hard to use your hands or walk without pain. It can also damage your joints over time.

There’s currently no cure for PsA,  but treatments are available to help improve symptoms and reduce flare-ups. One option is a biologic medication called Cosentyx (secukinumab). But how does Cosentyx work for PsA? And what else should you know before you take it?

What is Cosentyx?

Cosentyx (secukinumab) is an injectable medication that treats several autoimmune diseases, including PsA. It’s a monoclonal antibody — a lab-made protein that targets certain cells in your body to fight disease.

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Cosentyx was FDA approved in 2016 to treat PsA. It’s also FDA approved to treat plaque psoriasis, ankylosing spondylitis, and non-radiographic axial spondyloarthritis. In 2021, it was also FDA approved to treat children and teens with enthesitis-related arthritis (ERA) and juvenile PsA (JPsA).

How does Cosentyx work for psoriatic arthritis?

In autoimmune diseases like PsA, the body attacks its own healthy tissues. This leads to inflammation, which can cause joint damage. This is where monoclonal antibodies like Cosentyx can help.

Cosentyx blocks a protein called interleukin-17A (IL-17A). The protein is naturally present in the body, but too much of it (as seen in people with PsA) causes inflammation and swelling. By blocking IL-17A, Cosentyx can improve PsA symptoms, including:

• Joint pain

• Joint swelling 

• Swelling of fingers or toes (dactylitis)

• Pain where tendons and ligaments connect to bones (enthesitis)

• Psoriasis skin plaques

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Disease-modifying antirheumatic drugs (DMARDs) are commonly used to treat PsA and rheumatoid arthritis (RA). DMARDs actually alter the course of a disease itself instead of only treating symptoms. 

Cosentyx is a biologic DMARD. It not only helps improve PsA symptoms, but it also helps slow down the disease to reduce permanent joint damage. Cosentyx can be given alone or in combination with other DMARDs, such as methotrexate. The treatment strategy that’s best for you depends on your symptoms and medical history. 

How is Cosentyx given when treating psoriatic arthritis?

Cosentyx is given as an injection under the skin or an infusion into a vein (IV). You can give yourself the injection at home once you’ve been trained to do so. But the infusion needs to be given in a healthcare provider’s office or an infusion center.

Cosentyx dosing for PsA 

The recommended Cosentyx dosage for PsA varies. When first starting it, some people will receive one 150 mg injection under the skin every week for 5 weeks — this is called a loading dosage. After your loading doses, you’ll need one 150 mg injection every 4 weeks. But some people may skip the loading dosage and start with just one 150 mg injection every 4 weeks. Your provider will help decide whether or not loading doses are needed. 

If your symptoms don’t improve, your healthcare provider may increase your dose to 300 mg every 4 weeks.

If you have both PsA and moderate to severe plaque psoriasis, your Cosentyx dosage is different. In this case, you’ll inject 300 mg once a week for 5 weeks, followed by 300 mg every 4 weeks.

If you’re receiving a Cosentyx infusion, your dose is calculated based on your body weight. The recommended dosage is 1.75 mg per kilogram body weight (up to 300 mg) infused every 4 weeks. In some cases, you’ll start with a one-time loading dose of 6 mg per kilogram body weight, followed by the lower recommended dosage every 4 weeks thereafter.

Children ages 2 and over with JPsA receive a Cosentyx dosage based on their body weight. It’s recommended that children receive loading doses once a week for the first 5 weeks, followed by an injection once every 4 weeks.

How and where do you inject Cosentyx?

You can inject Cosentyx into your stomach, the top of your thighs, and your upper outer arms. Most people choose the stomach or thigh if they’re injecting Cosentyx themselves. You’ll want to remove your dose from the refrigerator about 30 minutes before your injection. This helps reduce pain when you inject it.

Cosentyx injections come in a pre-filled syringe or two types of auto-injector pens. Each is a single-use dose — so you shouldn’t use them more than once. The syringe should be injected at a 45-degree angle to the skin. The auto-injector pens should be pressed against the skin at a 90-degree angle, and they’ll automatically inject the medication once they’re in place. 

It’s best to alternate where you inject Cosentyx with each dose. You can inject it at any time of the day, regardless of meals. Remember that you’ll need alcohol swabs and a sharps container at home for your injections, too.

What are the potential side effects of Cosentyx?

Like all medications, Cosentyx may cause side effects. Some are mild, but others can be more serious and should be discussed with your healthcare provider right away. 

Common side effects

The most common side effects of Cosentyx are: 

• Runny or stuffy nose

• Sore throat

• Headache

• Nausea

• Upper respiratory infections

• Increased cholesterol levels

Serious side effects

The following side effects are serious and should be reported to your healthcare provider immediately:

• Allergic reactions (skin rash, itching, or swollen face or mouth)

• Trouble breathing

• Signs and symptoms of infection (fever, chills, or cough)

• Signs and symptoms of inflammatory bowel disease (stomach pain, severe diarrhea, or blood in stool)

Because Cosentyx affects your immune system, it can increase your risk of having infections. Before starting Cosentyx, tell your healthcare provider if you have or have been exposed to tuberculosis, are being treated for an infection, or have symptoms of an infection.

How effective is Cosentyx at treating psoriatic arthritis?

Cosentyx was approved to treat PsA in adults based on two studies: the FUTURE 1 and FUTURE 2 studies. The two studies together looked at over 1,000 adults. Both were randomized controlled trials that compared Cosentyx to a placebo (an injection that doesn’t contain medication). 

The researchers wanted to know if Cosentyx provided greater symptom improvement (at least 20% better) than placebo after 6 months. In both studies, about 50% of people taking Cosentyx had at least a 20% improvement in PsA symptoms after 6 months versus about 15% of people taking the placebo. This showed that Cosentyx was better than the placebo at improving PsA symptoms.

A third study, the FUTURE 5 clinical trial, was performed after Cosentyx was FDA approved to treat PsA. The study showed that about 55% to 60% of people taking Cosentyx had symptom improvement after 4 months of treatment.

Another clinical trial, the JUNIPERA study, led to the FDA’s approval of Cosentyx for JPsA and ERA. The study showed that Cosentyx was better than placebo at delaying symptom flare-ups in children and teens with JPsA or ERA.

In a real-world setting, people report being very satisfied with their Cosentyx treatment and are likely to stick with it.

How to save on Cosentyx

There are ways to save on Cosentyx, which is only available as a brand-name medication. GoodRx can help you navigate between patient assistance programs and copay savings cards to save money on your prescription.

• Save with a copay savings card. If you have commercial insurance, you may be eligible to pay as little as $0 for Cosentyx using a savings card from the manufacturer.

• Save with patient assistance programs. If you’re uninsured or underinsured, you may be eligible for Cosentyx’s patient assistance program, which offers the medication free of cost.

What are some alternatives to Cosentyx?

You and your healthcare provider will decide what PsA treatment is best for you based on the symptoms you have and how severe they are. Other health conditions and any previous treatments will likely be considered as well.

A few other medications used for PsA include nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroid injections. But these are usually for mild PsA. Methotrexate or injectable biologics like Cosentyx are used for more severe PsA. Other injectable biologics that treat PsA include:

• Cimzia (certolizumab pegol)

• Enbrel (etanercept)

• Humira (adalimumab)

• Orencia (abatacept)

• Remicade (infliximab)

• Simponi (golimumab)

• Stelara (ustekinumab)

• Skyrizi (risankizumab)

• Taltz (ixekizumab)

Other alternatives to Cosentyx include oral tablets like Otezla (apremilast) and Xeljanz (tofacitinib).

Why trust our experts?

Written by:

Nikki Javit, PharmD

Nikki Javit, PharmD, is a clinical pharmacist with certifications in international travel medicine, immunization delivery, and pharmacogenomics. She received her bachelor’s of science in biology from Indiana University Bloomington and her doctor of pharmacy degree from Butler University.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

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