Chemistry:Secukinumab

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Short description: Monoclonal antibody against IL-17
Secukinumab
Autoinjector with Cosentyx by Novartis (Secukinumab)-0522.jpg
Autoinjector with Cosentyx by Novartis (Secukinumab)
Monoclonal antibody
TypeWhole antibody
SourceHuman
TargetIL17A
Clinical data
Trade namesCosentyx
Other namesAIN457
AHFS/Drugs.comMonograph
MedlinePlusa615011
License data
Pregnancy
category
  • AU: C
Routes of
administration		Subcutaneous, intravenous
ATC code
Legal status
Legal status
Identifiers
CAS Number
DrugBank
ChemSpider
  • none
UNII
KEGG
Chemical and physical data
FormulaC6584H10134N1754O2042S44
Molar mass147944.37 g·mol−1
 ☒N☑Y (what is this?)  (verify)

Secukinumab, sold under the brand name Cosentyx among others, is a human IgG1κ monoclonal antibody used for the treatment of psoriasis, ankylosing spondylitis, and psoriatic arthritis.[3][4][5] It binds to the protein interleukin (IL)-17A and is marketed by Novartis.[3][4][5]

Medical uses

Secukinumab is used to treat psoriasis, ankylosing spondylitis, and psoriatic arthritis.[3][4][5][6] It is given by subcutaneous injection and is sold in a pre-filled syringe or autoinjector that can be used at home and as a lyophilized powder for use in hospitals and clinics.[4] In October 2023, the FDA approved a intravenous variant of secukinumab.[7]

Secukinumab was not tested in pregnant women; animal studies did not show harm at relevant doses. The US Food and Drug Administration advises that the drug should be used in pregnant women only if the risk to the fetus is justified by the potential benefit;[4] the European Medicines Agency (EMA) advises that women should not become pregnant while taking it.[3]

In the European Union, secukinumab is indicated for the treatment of:[5]

  • moderate to severe plaque psoriasis in adults, children and adolescents from the age of six years who are candidates for systemic therapy.[5]
  • active psoriatic arthritis in adults, alone or in combination with methotrexate (MTX), when the response to previous disease modifying anti rheumatic drug (DMARD) therapy has been inadequate.[5]
  • active ankylosing spondylitis in adults who have responded inadequately to conventional therapy.[5]
  • active non-radiographic axial spondyloarthritis with objective signs of inflammation as indicated by elevated C-reactive protein (CRP) and/or magnetic resonance imaging (MRI) evidence in adults who have responded inadequately to non steroidal anti inflammatory drugs (NSAIDs).[5]
  • active moderate to severe hidradenitis suppurativa in adults with an inadequate response to conventional systemic HS therapy.[5]
  • active enthesitis-related arthritis in patients 6 years and older whose disease has responded inadequately to, or who cannot tolerate, conventional therapy.[5]
  • active juvenile psoriatic arthritis in patients 6 years and older whose disease has responded inadequately to, or who cannot tolerate, conventional therapy.[5]

Adverse effects

Very common (greater than 10% of people experience them) adverse effects include upper respiratory tract infections.[3]

Common (between 1% and 10% of people experience them) include oral herpes, runny nose, and diarrhea.[3] Injection site reactions are common, occurring in approximately 1.9% of cases.[8]

In clinical trials there were rare instances of hypersensitivity reactions, severe infections, and some cases of serious inflammatory bowel disease, some of which were new and some of which were exacerbations of existing conditions.[4] Caution should be used when starting secukinumab in patients with inflammatory bowel disease, and patients being treated with secukinumab should be monitored for signs and symptoms of inflammatory bowel disease.[9]

Pharmacology

Secukinumab inhibits a member of the cytokine family, interleukin 17A, which is produced mainly by inflammatory T helper 17 cells.[10] IL17A is upregulated in serum of people with psoriasis and in the synovial fluid of people with psoriatic arthritis, and promotes inflammation when it binds to the interleukin-17 receptor which is expressed in various types of cells, including keratinocytes in skin.[10][11]

It is mostly eliminated by being taken up into cells via endocytosis and being broken down inside them.[3]

Chemistry

Secukinumab is a recombinant fully human IgG1/kappa monoclonal antibody and is manufactured in Chinese hamster ovary cells.[3]

History

Secukinumab was discovered and developed by Novartis using developmental name AIN457, and the first publication was a Phase I trial published in 2010.[12][13][14][15]

In January 2015, secukinumab was approved in the United States and in the European Union to treat adults with moderate-to-severe plaque psoriasis.[16][17][5] It is the first IL17A inhibiting drug ever approved.[11] In January 2016, the FDA approved it to treat adults with ankylosing spondylitis, and psoriatic arthritis and in February 2018, a label update was approved to include the treatment for moderate-to-severe scalp psoriasis.[18][19]

References

  1. ↑ "Cosentyx (Novartis Pharmaceuticals Australia Pty Ltd)". 7 October 2022. https://www.tga.gov.au/resources/prescription-medicines-registrations/cosentyx-novartis-pharmaceuticals-australia-pty-ltd-2. 
  2. ↑ "Prescription medicines: registration of new chemical entities in Australia, 2015". 21 June 2022. https://www.tga.gov.au/prescription-medicines-registration-new-chemical-entities-australia-2015. 
  3. ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 "Cosentyx 150mg and 300mg solution for injection in pre-filled syringe and pre-filled pen - Summary of Product Characteristics (SmPC)". 6 June 2022. https://www.medicines.org.uk/emc/medicine/29848. 
  4. ↑ 4.0 4.1 4.2 4.3 4.4 4.5 4.6 "Cosentyx- secukinumab injection". 4 November 2022. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=77c4b13e-7df3-42d4-81db-3d0cddb7f67a. 
  5. ↑ 5.00 5.01 5.02 5.03 5.04 5.05 5.06 5.07 5.08 5.09 5.10 5.11 5.12 "Cosentyx EPAR". 17 September 2018. https://www.ema.europa.eu/en/medicines/human/EPAR/cosentyx.  Text was copied from this source which is © European Medicines Agency. Reproduction is authorized provided the source is acknowledged.
  6. ↑ "A Review of the Use of Secukinumab for Psoriatic Arthritis". Rheumatology and Therapy 4 (2): 233–246. December 2017. doi:10.1007/s40744-017-0076-0. PMID 28849401. 
  7. ↑ "FDA Approves Intravenous Variant of Secukinumab for Psoriatic Arthritis, Other Arthritis Types" (in en). 6 October 2023. https://www.hcplive.com/view/fda-approves-intravenous-variant-secukinumab-psoriatic-arthritis-other-arthritis-types. 
  8. ↑ "A Systematic Review and Meta-Analysis of Injection Site Reactions in Randomized-Controlled Trials of Biologic Injections". Journal of Cutaneous Medicine and Surgery 27 (4): 358–367. July 2023. doi:10.1177/12034754231188444. PMID 37533141. 
  9. ↑ "TH17 Cells in Autoimmunity and Immunodeficiency: Protective or Pathogenic?". Frontiers in Immunology 3: 129. 2012. doi:10.3389/fimmu.2012.00129. PMID 22675324. 
  10. ↑ 10.0 10.1 "Secukinumab for ankylosing spondylitis and psoriatic arthritis". Therapeutics and Clinical Risk Management 12: 1587–1592. 2016. doi:10.2147/TCRM.S100091. PMID 27799780. 
  11. ↑ 11.0 11.1 "Secukinumab: A Review in Psoriatic Arthritis". Drugs 76 (11): 1135–1145. July 2016. doi:10.1007/s40265-016-0602-3. PMID 27299434. 
  12. ↑ "Development trends for human monoclonal antibody therapeutics". Nature Reviews. Drug Discovery 9 (10): 767–774. October 2010. doi:10.1038/nrd3229. PMID 20811384. 
  13. ↑ "Effects of AIN457, a fully human antibody to interleukin-17A, on psoriasis, rheumatoid arthritis, and uveitis". Science Translational Medicine 2 (52): 52ra72. October 2010. doi:10.1126/scitranslmed.3001107. PMID 20926833. 
  14. ↑ "Novartis Snags Remaining 23% Stake in Alcon with $12.9B Cash and Share Deal". Genetic Engineering News. 15 December 2010. http://www.genengnews.com/gen-news-highlights/novartis-snags-remaining-23-stake-in-alcon-with-12-9b-cash-and-share-deal/81244384. 
  15. ↑ "US 7807155: IL-17 antagonistic antibodies". 2010. https://www.google.com/patents/US7807155. 
  16. ↑ "Drug Approval Package: Cosentyx (secukinumab) NDA #125504". 24 December 1999. https://www.accessdata.fda.gov/drugsatfda_docs/nda/2015/125504Orig1s000TOC.cfm. 
  17. ↑ "FDA approves new psoriasis drug Cosentyx" (Press release). U.S. Food and Drug Administration (FDA). 21 January 2015. Archived from the original on 22 January 2015. Retrieved 21 January 2015.
  18. ↑ "Novartis receives two new FDA approvals for Cosentyx to treat patients with ankylosing spondylitis and psoriatic arthritis in the US" (Press release). Novartis. 15 January 2016.
  19. ↑ "FDA Approves Label Update for Secukinumab". http://www.mdmag.com/medical-news/fda-approves-label-update-for-secukinumab. 



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