Names and pronunciation
(sek′-ue-kin′-ue-mab) Cosentyx, Cosentyx Sensoready, Cosentyx Sensoready Pen
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Drug reference
(sek′-ue-kin′-ue-mab) Cosentyx, Cosentyx Sensoready, Cosentyx Sensoready Pen
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Func. class.: Immune response modifier
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Chem. class.: Monoclonal antibody
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ACTION: Interleukin (IL)-12, IL-23 antagonist, decrease inflammatory response
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USES: Plaque psoriasis, ankylosing spondylitis, psoriatic arthritis, axial spondyloarthritis
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CONTRAINDICATIONS: Hyper- sensitivity, active TB Precautions: Pregnancy, breastfeeding, Crohn’s disease, infection, latex hyper- sensitivity, vaccination
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SIDE EFFECTS EENT: Ocular infections, sinusitis, oral ulceration, rhinitis GI: Diarrhea HEMA: Bleeding INTEG: Injection-site reaction, urticaria SYST: Serious infections, anaphylaxis, antibody formation, candidiasis RESP: URI
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INTERACTIONS • Do not give concurrently with vac- cines; immunizations should be brought up-to-date before treatment • Avoid use with immunosuppressives Drug/Lab tests Increase: LFTs
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DOSAGE AND ROUTES Ankylosing spondylitis • Adult: SUBCUT 150 mg at weeks 0, 1, 2, 3, and 4 and q4wk thereafter, or 150 mg SUBCUT q4wk Psoriatic arthritis • Adult: SUBCUT 150 mg at weeks 0, 1, 2, 3, and 4 and q4wk thereafter; may give with or without methotrexate; may consider a dose of 300 mg if active disease persists Psoriatic arthritis with plaque psoriasis: • Adult: SUBCUT Initially, 300 mg (2 injections of 150 mg) at weeks 0, 1, 2, 3, and 4; Maintenance: 300 mg (2 injec- tions of 150 mg) q4wk
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Available forms: Solution for injection 150 mg/mL (pen, prefilled syringe), 2-pack and single
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Administer: • Visually inspect for particulate matter or discoloration; solution should be slightly yellow and may contain a few small trans- lucent or white particles; do not use if discolored, cloudy, or if foreign particu- late matter is present; do not shake • Use a 27-G, 0.5-inch needle • May be administered SUBCUT into upper arm, abdomen, or thigh; rotate injection sites • Use by SUBCUT injection only • Those with latex hypersensitivity should not handle cap SUBCUT injection: • Patients may use the prefilled syringe or Sensoready pen after proper training; the lyophilized powder is for health care provider use only • Each 300-mg dose is used as 2 SUB- CUT injections of 150 mg • Do not administer where skin is ten- der, bruised, erythematous, indurated, or affected by psoriasis • Reconstitution of lyophilized powder: allow to warm to room temperature for 15-30 min, use 1 mL sterile water for injection to reconstitute, rotate, do not shake or invert vial, allow to stand for 10 min, again rotate vial, allow to stand for another 5 min (150 mg/mL) • Storage: use immediately or refrigerate for up to 24 hr. Do not freeze. If refrigerated, allow reconstituted solution to reach room temperature (15-30 min) before administration • Preparation for use of prefilled sy- ringe or Sensoready pen: remove pre- filled syringe or Sensoready pen from refrigerator and allow 15-30 min to reach room temperature • Storage: the prefilled syringe or Sen- soready should be used within 1 hr
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Assess: • TB: TB testing should be done before starting treatment • For injection-site pain, swelling • Bring immunizations up-to-date before starting treatment • Infection: monitor for fever, sore throat, cough; do not use during active infections • Malignancy: skin cancer may occur, S especially in older patients who have used ultraviolet treatments with immuno- suppressants • Pregnancy/breastfeeding: use only if benefits outweigh fetal risk; cautious use in breastfeeding, excretion unknown
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Evaluate: • Therapeutic response: decreased plaque psoriasis
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • That product must be continued for prescribed time to be effective; to use as prescribed • Not to receive live vaccinations during treatment; that vaccinations should be brought up-to-date before use of this product • To notify prescriber of possible infec- tion (upper respiratory or other) or al- lergic reactions • To report to provider the presence of inflammatory bowel disease, persistent diarrhea; product can cause inflamma- tory bowel disease • To report latex allergy; prefilled injection device (Sensoready) may contain latex • Not to use pen if fluid contains particu- late; to use within 1 hr of removing from refrigerator • Injection techniques and disposal of equipment; not to reuse needles, sy- ringes; to rotate injection sites with each dose; not to inject into bruised or dam- aged skin
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PHARMACOKINETICS Maximum serum concentration: 13.5 days after a single 45-mg SUBCUT dose, 7 days after a single 90-mg SUBCUT dose; half-life 14.9-45.6 days
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• Adult: SUBCUT 150 mg at weeks 0, 1, 2, 3, and 4 and q4wk thereafter, or 150 mg SUBCUT q4wk Psoriatic arthritis
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• Adult: SUBCUT 150 mg at weeks 0, 1, 2, 3, and 4 and q4wk thereafter; may give with or without methotrexate; may consider a dose of 300 mg if active disease persists Psoriatic arthritis with plaque psoriasis:
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• Adult: SUBCUT Initially, 300 mg (2 injections of 150 mg) at weeks 0, 1, 2, 3, and 4; Maintenance: 300 mg (2 injec- tions of 150 mg) q4wk
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