Does Cosentyx treat Rheumatoid Arthritis?
Rheumatoid arthritis is NOT an approved indication for Cosentyx, but some people may use it off-label, if the doctor and patient believe it may be of benefit.
Cosentyx (secukinumab) is an immunosuppressant that reduces the effects of a chemical substance in the body that can cause inflammation, it does this by binding to a protein called interleukin 17A (IL-17a.) It belongs to the group of medicines called biological DMARDs (disease-modifying anti-rheumatic drugs).
What conditions is Cosentyx an approved medicine by the FDA?
Cosentyx is FDA-approved to specifically to treat these patients:
- moderate to severe plaque psoriasis (raised, silvery flaking of the skin) in patients 6 years and older, who are who are candidates for systemic therapy or phototherapy.
- active psoriatic arthritis (PsA) for patients 2 years and older.
- active ankylosing spondylitis (AS) in adults.
- active non-radiographic axial spondyloarthritis (nr-axSpA) in adults, who have objective signs of inflammation.
- active enthesitis-related arthritis (ERA) in patients who are 4 years and older
- moderate to severe hidradenitis suppurativa (HS) in adults.
Does Cosentyx treat rheumatoid arthritis?
- Some people may use Cosentyx for rheumatoid arthritis (RA) but it is an off-label use.
- This means that rheumatoid arthritis is not an approved condition for Cosentyx, but the doctor and patient believe it may be of benefit.
- Cosentyx is currently not FDA approved for use with rheumatoid arthritis and clinical trials would be needed to prove that Cosentyx works for RA better than already available products.
Have any studies been completed on Cosentyx treating rheumatoid arthritis?
There have been a number of trials done to see how well Cosentyx works for RA. They have shown that Cosentyx does show an improvement in RA when compared to placebo, but the benefits were often not clinically significant. One of the studies was stopped when they realised that abatacept worked better than Cosentyx in RA.
NURTURE 1 clinical trial:
- This trial was to compare Cosentyx with abatacept (Orencia) in treating patients with RA to see which one worked best.
- The trial showed that for RA, abatacept worked better than Cosentyx
- After 24 weeks the number of patients that had a 50% improvement in their symptoms was 27.5% for abatacept, 16.8% for Cosentyx (150mg) and placebo was 9.4%.
REASSURE clinical trial:
- Results showed Cosentyx works better than a placebo for rheumatoid arthritis.
- The measure of how well a RA patient can function and how much disability they have is measured by the Health Assessment Questionnaire-Disability Index (HAQ-DI). This did not improve enough when taking Cosentyx to be statistically significant.
- They also measured whether there was any improvement in joint or bone damage, erosion and joint space narrowing (radiographic score) but there was not a clinically significant improvement.
- This study was stopped after the NUTURE 1 study showed abatacept worked better than Cosentyx for RA.
REASSURE2 clinical trial:
- Although some patients on Cosentyx showed an improvement in RA, it was not statistically significantly better than placebo.
What else can be used to treat RA?
There are a number of biological DMARDs used to treat RA.
| Generic Name | Brand Name | Action |
|---|---|---|
| abatacept | Orencia | Selective T cell costimulation modulator (inhibits T cell activation) |
| adalimumab | Humira | Tumor necrosis factor (TNF) inhibitor |
| anakinra | Kineret | Interleukin-1 Receptor Antagonist (IL-1RA) |
| certolizumab | Cimzia | TNF inhibitor |
| etanercept | Enbrel | TNF inhibitor |
| golimumab | Simponi | TNF inhibitor |
| infliximab | Remicade | TNF inhibitor |
| baricitinib | Olumiant | Janus Kinase (JAK) inhibitor |
| rituximab | Rituxan | CD20-directed cytolytic antibody (mediates B-cell lysis) |
| sarilumab | Kevzara | Interleukin-6 receptor (IL-6) antagonist |
| tocilizumab | Actemra | IL-6 antagonist |
| tofacitinib | Xeljanz, Xeljanz XR | Janus Kinase (JAK) inhibitor |
Related questions
- What are Monoclonal Antibodies and how do they work?
- What are IL-17 Inhibitors and how do they work?
- How does Taltz compare to Cosentyx for psoriatic arthritis?
Is Cosentyx an FDA approved medicine for RA?
- No, Cosentyx is not FDA approved for use for RA
- Cosentyx is FDA approved for treating moderate to severe plaque psoriasis, ankylosing spondylitis, psoriatic arthritis in adults and non-radiographic axial spondyloarthritis (nr-axSpA).
Bottom line:
- Some people may use Cosentyx for rheumatoid arthritis (RA) but it is an off-label use.
- Other biological DMARDs have been proven in clinical trials to be more effective in treating rheumatoid arthritis than Cosentyx.
See also:
- Rheumatoid Arthritis: Symptoms, Diagnosis & Treatment Options
- Drug Treatments for Rheumatoid Arthritis: What Are Your Options?
References
- FDA Cosentyx product label: Information: https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/761349s000lbl.pdf
- Rheumatoid Arthritis: Symptoms, Diagnosis & Treatment Options: https://www.drugs.com/condition/rheumatoid-arthritis.html
- Drug Treatments for Rheumatoid Arthritis: What Are Your Options?https://www.drugs.com/condition/rheumatoid-arthritis.html
- Secukinumab in Active Rheumatoid Arthritis after Anti-TNFα Therapy: A Randomized, Double-Blind Placebo-Controlled Phase 3 Study: https://link.springer.com/article/10.1007/s40744-017-0086-y
- Efficacy and safety of secukinumab in active rheumatoid arthritis with an inadequate response to tumor necrosis factor inhibitors: a meta-analysis of phase III randomized controlled trials: https://pubmed.ncbi.nlm.nih.gov/31087226/
- https://clinicaltrials.gov/study/NCT01350804
- Secukinumab in Active Rheumatoid Arthritis: A Phase III Randomized, Double-Blind, Active Comparator- and Placebo-Controlled Study: https://pubmed.ncbi.nlm.nih.gov/28217871/
- https://clinicaltrials.gov/study/NCT01770379
- https://pubmed.ncbi.nlm.nih.gov/31087226/ https://clinicaltrials.gov/study/NCT01377012
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