What is secukinumab?
Secukinumab (brand name Cosentyx) is a biologic medication used to treat psoriatic arthritis, ankylosing spondylitis, and plaque psoriasis. It is a self-injectable medication given under the skin (subcutaneously) using a prefilled Sensoready pen or prefilled syringe.
How it works
Secukinumab is a monoclonal antibody that blocks a specific protein called interleukin-17A (IL-17A). IL-17A is a key driver of inflammation in psoriatic and spondylitic disease. By targeting this single protein, secukinumab reduces inflammation without broadly suppressing your entire immune system — it is a very targeted therapy.
How it’s given
Secukinumab is self-administered at home as a subcutaneous (under the skin) injection.
- Loading phase: 150 mg or 300 mg injected once weekly for 5 weeks (weeks 0, 1, 2, 3, and 4). Your dose depends on your specific condition.
- Maintenance phase: The same dose every 4 weeks after completing the loading phase.
Your rheumatologist will determine the right dose for your indication. Secukinumab does not need to be combined with methotrexate.
Storage: Keep secukinumab refrigerated. Remove it from the refrigerator about 30 minutes before your injection to allow it to reach room temperature — this makes the injection more comfortable.
What to expect when starting
Many patients notice improvement within 3 to 4 weeks, especially in skin symptoms. Joint symptoms may take somewhat longer to respond. The loading phase (weekly injections for the first month) helps the medication reach effective levels in your body more quickly.
Side effects to watch for
Secukinumab is generally well-tolerated with a favorable safety profile. The most common side effects include:
- Upper respiratory infections (cold-like symptoms)
- Injection site reactions (redness, swelling, or mild discomfort at the injection site)
- Oral candidiasis (thrush — a fungal infection in the mouth)
- Diarrhea
Most side effects are mild and manageable. Contact your rheumatologist if you develop signs of infection such as fever, persistent cough, or symptoms that concern you.
Required screening before starting
Before beginning secukinumab, your rheumatologist will order:
- Tuberculosis (TB) testing — standard for all biologic medications
This helps ensure it is safe for you to start treatment.
Things to avoid
- Live vaccines should not be given while you are on secukinumab. Talk to your rheumatologist before receiving any vaccinations. Inactivated vaccines (such as the flu shot) are safe and recommended.
Important: Secukinumab and other IL-17 inhibitors should not be used in patients with active inflammatory bowel disease (Crohn’s disease), as they can worsen IBD symptoms. If you have any history of bowel problems — including chronic diarrhea, bloody stools, or a prior IBD diagnosis — discuss this with your rheumatologist before starting.
Frequently asked questions
Do I need to take methotrexate with secukinumab? No. Unlike some other biologics, secukinumab works well on its own and does not require combination with methotrexate.
Will this medication make me immunocompromised? Secukinumab targets a single inflammatory protein (IL-17A) rather than broadly suppressing your immune system. While any biologic modestly increases infection risk, most patients do not experience significant immune suppression.
Can I travel with my medication? Yes. Keep it in an insulated travel cooler during transport. Many patients successfully travel with their Sensoready pen.
What if I miss a dose? Inject the missed dose as soon as you remember, then resume your regular schedule. Contact your rheumatologist’s office if you are unsure.
How long will I need to take this medication? Secukinumab is typically a long-term treatment. If it is working well and you are tolerating it, your rheumatologist will generally recommend continuing it. Stopping may lead to a return of symptoms.
This handout is for informational purposes only and does not replace the advice of your rheumatologist. Always discuss your specific medical situation, including all medications and health conditions, with your provider before starting or changing any treatment.