Is Cosentyx Effective for Hidradenitis Suppurativa?

Cosentyx (secukinumab) received FDA approval in October 2023 for the treatment of moderate to severe hidradenitis suppurativa (HS) in adults. It is notable as the first medication in its class—an IL-17A inhibitor—approved specifically for HS, offering a new option for patients who may not have responded to previous therapies. In this article, we will review how effective Cosentyx is for hidradenitis suppurativa and answer other frequently asked questions.

How Cosentyx Works for Hidradenitis Suppurativa

Cosentyx is a biologic medication that targets and blocks interleukin-17A (IL-17A), a protein in the immune system that plays a key role in inflammation. By inhibiting IL-17A, Cosentyx helps reduce the overactive immune response that leads to the formation of painful nodules, abscesses, and flares characteristic of HS. This targeted approach aims to interrupt the cycle of inflammation and tissue damage in the skin.

How Do You Take Cosentyx For Hidradenitis Suppurativa?

Cosentyx is given as an injection under the skin. You should receive training on how to give the injections if you are taking the medication at home.

The usual dose for HS is 300 mg injected under the skin on Week 0, 1, 2, 3, 4, and then every 4 weeks. Depending on your response, your healthcare provider might recommend taking 300 mg every 2 weeks.

Clinical Trial Data: Efficacy Results

The effectiveness of Cosentyx for HS was established in two large clinical trials, SUNSHINE and SUNRISE. The primary outcome measured was the number of patients that achieved a Hidradenitis Suppurativa Clinical Response (HiSCR50), defined as at least a 50% reduction in the number of abscesses and inflammatory nodules with no increase in abscesses or draining tunnels. The studies showed:

• About 42% of patients receiving Cosentyx achieved a HiSCR50 at 16 weeks, compared to approximately 30% taking a placebo.
• The benefits of Cosentyx were sustained, with more than half of patients maintaining improvement through 52 weeks in extension studies.

When Does Cosentyx Start Working For Hidradenitis Suppurativa?

Patients may begin to notice improvements as early as 2 weeks after starting Cosentyx, but most will see significant results within 3 to 4 months (12–16 weeks). Some individuals continue to experience further improvement over 6 to 12 months, with benefits maintained for at least a year in many cases.

Comparison to Other Treatments For Hidradenitis Suppurativa

Treatment of HS includes a combination of wound care, pain management, and medications to reduce symptoms. Initial treatments typically consist of antibiotics and antiandrogenic medications. After failure of these medications, healthcare providers may consider a biologic medication, like Cosentyx.

In addition to Cosentyx, other biologic options for HS include:

• Adalimumab (Humira): Previously the only FDA-approved biologic for HS, Humira works by blocking a different inflammatory protein (TNF-alpha). In studies, 42-59% of patients taking Humira achieved an HiSCR50 at 12 weeks compared to about 30% of patients taking a placebo.
• Bimekizumab (Bimzelx): Another IL-17 inhibitor, Bimzelx targets both IL-17A and IL-17F and has shown promising results in clinical trials. In studies, 48-52% of patients achieved HiSCR50 compared to about 30% of patients taking a placebo at week 16.
• Infliximab (Remicade): An anti-TNF biologic that is not FDA approved for HS, but limited research has shown it is an effective treatment option for HS (response rate of 83%). Larger trials are needed to confirm its benefits.

Direct head-to-head clinical trials comparing all available biologics for HS are still limited. However, network meta-analyses that statistically compare multiple treatments from various trials offer valuable insights into their relative effectiveness.

A network meta-analysis published in the Indian Journal of Dermatology, Venereology and Leprology concluded that while adalimumab (Humira) currently holds a slight edge as the best initial biologic strategy, secukinumab (Cosentyx) follows closely behind as a highly effective option. Individual results vary, and Cosentyx may be an option for patients who have not had success with other biologics.

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Patient Experience and Real-World Use Of Cosentyx

While clinical trials provide rigorous data on Cosentyx’s efficacy and safety for hidradenitis suppurativa (HS), patient experiences shared on forums and social platforms offer valuable real-world perspectives.

• Positive experiences: Patients have reported a reduced number of lesions after starting Cosentyx. Some have stated that by week 5, they felt “like a new person.” Another user with HS on Reddit reported not having a new flare in the 18 months they have been taking Cosentyx.
• Mixed outcomes: Not all patients respond well. Some report that Cosentyx worked initially, but lost effectiveness over time. Others report experiencing side effects, such as infections, while taking Cosentyx. One user on Reddit reported there has been no change in their HS after 4 months of taking Cosentyx.

Keep in mind that everyone’s experience is different, and your experience may differ compared to what others have posted online.

Important Considerations

Before starting Cosentyx, there are several important considerations.

• Eligibility: Not everyone is a candidate for Cosentyx. Doctors will assess for infections and other health conditions before prescribing it.
• Administration: Cosentyx is given as an injection under the skin, usually at home after initial training.
• Side Effects: The most common side effects include an increased risk of infections (such as colds), diarrhea, and mild injection site reactions. Serious infections are rare but possible, so patients are screened before starting therapy.
• Immunizations: Before starting treatment, it is recommended to complete all vaccines per immunization guidelines. Live vaccines are not recommended during treatment with Cosentyx.

Summary

Cosentyx has demonstrated clinically meaningful benefits for many adults with moderate to severe hidradenitis suppurativa, helping to reduce painful symptoms and improve daily life. While it may not work for everyone, it represents an important new option, especially for those who have not responded to other treatments. Patients should discuss with their dermatologist or healthcare provider to determine if Cosentyx is appropriate for their individual situation.

This is not all the information you need to know about Cosentyx (secukinumab) for safe and effective use and does not take the place of your doctor’s directions. Review the full patient medication guide and discuss this information and any questions you have with your doctor or other health care provider.

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Drug information

• Cosentyx Information for Consumers
• Cosentyx prescribing info & package insert (for Health Professionals)
• Side Effects of Cosentyx (detailed)
• Cosentyx user reviews (252)

Related support groups

• Cosentyx (21 questions, 25 members)
• Hidradenitis Suppurativa (7 questions, 41 members)

Medical Disclaimer