Mechanism of Action
Cosentyx is a human monoclonal antibody that specifically binds to interleukin-17A (IL-17A), a cytokine involved in inflammatory and immune responses. By blocking the interaction of IL-17A with its receptor, Cosentyx drug inhibits the release of pro-inflammatory cytokines and chemokines. IL-17A plays a key role in the pathogenesis of psoriasis and psoriatic arthritis by promoting inflammatory cells to the skin and joints. By targeting this specific cytokine, Cosentyx is able to provide more selective immunosuppression compared to other biologics and small molecules that block multiple cytokines.
Clinical Trials
Cosentyx has been extensively studied in multiple Phase 2 and 3 randomized controlled trials involving thousands of patients with moderate to severe plaque psoriasis, psoriatic arthritis, and ankylosing spondylitis. In psoriasis studies, Cosentyx achieved significantly higher PASI 75, 90 and 100 response rates compared to placebo at week 12. These responses were maintained through week 52 of treatment. Cosentyx drug also led to rapid and significant improvements in itch, pain, scaling, and health-related quality of life. In psoriatic arthritis trials, Cosentyx drug reduced signs and symptoms including swollen and tender joint counts and achieved ACR20/50/70 responses, with benefits persisting to week 156. Cosentyx demonstrated a favorable safety profile comparable to placebo in all clinical studies to date.
Dosing and Administration
Cosentyx is available as a 150mg/mL solution in a single-dose pre-filled syringe or pen for subcutaneous injection. For plaque psoriasis, the recommended dosage is 300mg by subcutaneous injection at weeks 0, 1, 2, 3 and 4 followed by 300mg every 4 weeks. For psoriatic arthritis, the dosage is the same except the loading dose is spread over 5 weeks (150mg at weeks 0, 1, 2, 3, 4). Cosentyx can be self-administered or given by a healthcare professional after training. No laboratory monitoring is required during treatment. Cosentyx drug should not be used in patients with active systemic infections or latent tuberculosis until treated.
Safety and Tolerability
Overall, Cosentyx was well tolerated in clinical trials. The most common adverse events reported were nasopharyngitis, upper respiratory tract infection, and headache. Serious adverse events were observed in less than 5% of patients and included infections such as cellulitis, gastroenteritis and pneumonia. No opportunistic infections or cases of tuberculosis were reported. Cosentyx has a boxed warning for potential risk of infection but this was not borne out in the clinical trial experience to date. Rates of malignancy and major adverse cardiovascular events were similar between Cosentyx and placebo groups. Discontinuation rates due to adverse events were low at around 3%.
Advantages Over Other Biologics
Compared to tumor necrosis factor (TNF) inhibitors, Cosentyx offers the advantage of targeting a specific non-TNF cytokine pathway without impairing the TNF response, which is important for host defense against infections. Cosentyx has fewer drug-drug interactions than small molecules and does not require laboratory monitoring. In clinical trials Cosentyx demonstrated high PASI 75 and 90 responses with rapid onset within 2-4 weeks compared to 12-16 weeks for other biologics. Cosentyx drug can provide effective treatment for patients who have lost response or are intolerant to TNF inhibitors. Its convenient dosing regimen of every 4 weeks following an initial loading dose makes it preferable to biologics administered every 1-2 weeks.
Place in Psoriasis and Psoriatic Arthritis Treatment
Cosentyx drug has become a valuable treatment option for moderate to severe plaque psoriasis and active psoriatic arthritis based on its high efficacy, favorable safety profile and convenient dosing schedule. According to treatment guidelines, Cosentyx is recommended as a first-line biologic for psoriasis or psoriatic arthritis, used ahead of small molecules or after TNF inhibitors in some cases. Real-world evidence also supports Cosentyx as a cost-effective therapy with high retention rates compared to other biologics. With its IL-17A inhibition mechanism of action and numerous supporting clinical studies, Cosentyx drug has become an important treatment in dermatologists’ and rheumatologists’ armamentarium for psoriasis and psoriatic arthritis.
Gets More Insights on: Cosentyx Drug
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