Secukinumab: An Evidence-Based Guide for Patients

Secukinumab is a prescription biologic medicine used to treat several immune-mediated inflammatory conditions, including psoriasis and certain forms of arthritis. It works by blocking interleukin-17A (IL-17A), a signaling protein that can contribute to inflammation in the skin, joints and other tissues.

Overview: what secukinumab is and how it works

Secukinumab is a biologic medicine that helps control inflammation caused by an overactive immune response. It is not a steroid, conventional pain medicine or general immune supplement. Instead, it is a laboratory-made monoclonal antibody designed to block interleukin-17A (IL-17A), an immune signaling protein involved in inflammation.

In some immune-mediated diseases, IL-17A contributes to red, scaly skin plaques, joint swelling, pain, stiffness and inflammation where tendons attach to bone. By reducing this pathway’s activity, secukinumab can improve symptoms and physical function for many eligible patients. It controls disease activity but does not cure the underlying condition, so ongoing medical review remains important.

Secukinumab is administered as an injection under the skin. A clinician may give the first dose or teach the patient or caregiver how to inject it safely at home. The treatment schedule varies by condition, age, body weight and local prescribing guidance; some people receive more frequent doses at the beginning of therapy before moving to a maintenance schedule.

Conditions secukinumab may treat

Secukinumab is approved in many countries for moderate-to-severe plaque psoriasis in appropriate adults and, in some settings, children. Plaque psoriasis commonly causes well-defined, raised areas of inflamed skin with silvery scale. Treatment may be considered when topical therapies or light therapy have not provided adequate control, when disease is extensive, or when psoriasis substantially affects daily life.

It may also be used for active psoriatic arthritis, including disease affecting the joints, spine, tendons or digits. In psoriatic arthritis, treatment aims may include reducing pain and swelling, improving movement, protecting joint function and addressing skin symptoms. The medicine can also be an option for certain adults with ankylosing spondylitis, also called radiographic axial spondyloarthritis, and non-radiographic axial spondyloarthritis.

In some regions, secukinumab is additionally approved for adults with moderate-to-severe hidradenitis suppurativa, an inflammatory skin condition that can cause recurrent painful lumps and draining tunnels in areas such as the armpits and groin. Exact approved uses differ between countries, and a specialist will determine whether secukinumab is suitable for the individual diagnosis and treatment history.

Who may benefit and what to discuss before starting

Choosing a biologic treatment is individualized. A dermatologist, rheumatologist or other relevant specialist will consider the diagnosis, severity, areas of the body affected, previous treatments, other health conditions and the patient’s preferences. Secukinumab may be considered when a condition remains active despite other appropriate therapies, although the best sequence of treatments differs by disease and person.

Before starting, patients should tell their clinician about current or repeated infections, a history of tuberculosis, inflammatory bowel disease, cancer, immune-system conditions, planned operations and all medicines or supplements they use. It is especially important to mention persistent diarrhea, abdominal pain or blood in the stool, because IL-17-targeting medicines may trigger or worsen inflammatory bowel disease in some people.

Clinicians commonly assess for tuberculosis before treatment and may arrange other tests based on the person’s medical history and local recommendations. They will also review vaccinations. In general, recommended non-live vaccines can often be given, but live vaccines should usually be avoided during secukinumab treatment. Timing vaccines before treatment begins may be helpful, so patients should seek medical advice rather than delaying or receiving a vaccine on their own.

What treatment and follow-up may involve

Secukinumab is given by subcutaneous injection, meaning the medicine is injected into fatty tissue beneath the skin. Depending on the product available, it may come in a prefilled syringe, pen device or other formulation. A healthcare professional should demonstrate correct storage, preparation, injection technique and safe disposal of used needles before home administration.

Response times vary. Some people notice improvement in skin or joint symptoms within the first weeks, while a fuller response may take several months. The prescribing team will evaluate whether the medicine is reducing symptoms, improving daily activities and meeting agreed treatment goals. Patients should not change the dosing schedule or stop treatment without discussing it with the prescriber.

Follow-up appointments provide an opportunity to review infections, side effects, new symptoms and other medicines. For people with inflammatory arthritis, monitoring may include joint examinations and discussion of stiffness, fatigue, mobility and work or home activities. For skin conditions, clinicians may assess the extent of lesions, itch, pain, sleep effects and areas that are difficult to manage.

Possible side effects and safety considerations

Like all medicines, secukinumab can cause side effects, although not everyone experiences them. Commonly reported effects include symptoms of upper respiratory infection, such as a blocked or runny nose or sore throat, as well as diarrhea and cold sore outbreaks. Injection-site reactions, including redness, pain or swelling, may occur and are often mild, but should be discussed if persistent or troublesome.

Because secukinumab changes part of the immune response, it can increase susceptibility to infections. Patients should contact their healthcare team promptly if they develop fever, chills, shortness of breath, a persistent cough, painful urination, worsening skin redness, or another possible sign of infection. A clinician may advise postponing a dose when there is a significant active infection; patients should follow individualized medical guidance.

Rarely, serious allergic reactions may occur. Urgent medical help is needed for swelling of the face, lips, mouth or throat; breathing difficulty; widespread hives; faintness; or a rapidly worsening rash. New or worsening inflammatory bowel disease symptoms, including ongoing abdominal pain, persistent diarrhea, unexplained weight loss or blood in stools, also warrant timely clinical assessment.

Everyday practical advice during treatment

Patients can support safe treatment by keeping an up-to-date medication list and informing doctors, dentists and pharmacists that they use secukinumab. They should ask their prescribing team about what to do if an injection is missed, rather than taking an extra dose or changing the timing independently. Medication should be stored exactly as instructed in its product information and protected from conditions that could affect its quality.

Healthy routines can complement, but not replace, prescribed care. For inflammatory skin and joint conditions, useful measures may include regular movement within comfortable limits, skin care advised by a clinician, adequate sleep, smoking cessation where relevant and attention to emotional wellbeing. Maintaining a symptom diary can help identify changes in pain, stiffness, lesions, bowel symptoms, infections or side effects between appointments.

Pregnancy, plans to conceive and breastfeeding should be discussed with the specialist before treatment decisions are made. Available safety information continues to develop, and the balance of treatment benefits and possible risks is different for each person. Patients should also ask before receiving any vaccine, starting a new prescription medicine or using herbal products, even if these seem routine.

When to seek medical care

Patients should seek urgent medical care for symptoms of a severe allergic reaction, including difficulty breathing, throat tightness, facial swelling, fainting or widespread hives. Urgent assessment is also appropriate for signs of a potentially serious infection, such as high fever, confusion, severe weakness, chest pain, significant shortness of breath or rapidly spreading redness and swelling of the skin.

Contact the prescribing clinician promptly for a persistent fever, cough, painful urination, recurrent infections, cold sores that are severe or widespread, or symptoms suggesting inflammatory bowel disease. These include new or worsening persistent diarrhea, abdominal pain, blood in the stool or unintended weight loss. The clinician can advise whether treatment should continue as planned and whether further assessment is needed.

Routine appointments are important even when symptoms improve. Acibadem International’s multidisciplinary specialists and JCI-accredited hospitals diagnose and treat immune-mediated inflammatory conditions for international patients, coordinating dermatology, rheumatology and other relevant care when needed. Any decision to start, continue or change secukinumab should be made with a qualified clinician familiar with the patient’s complete medical history.

Frequently asked questions

Is secukinumab a biologic medicine?

Yes. Secukinumab is a biologic monoclonal antibody that targets IL-17A, an immune signaling protein involved in several inflammatory diseases. It is given by injection under the skin and requires a prescription and clinical monitoring.

How long does secukinumab take to work?

Some people begin to notice improvement within the first few weeks, but the timing differs by condition and individual response. A clinician will usually assess progress over time rather than judging success after only one or two doses.

Can secukinumab increase infection risk?

Yes, it may make some infections more likely because it affects part of the immune system. Patients should tell their clinician about symptoms of infection and should not take a scheduled dose during a significant infection unless their healthcare professional advises them to do so.

Do patients need testing before taking secukinumab?

Testing for tuberculosis is commonly performed before starting treatment. A clinician may recommend additional tests or assessments depending on medical history, infection risk, other medicines and local clinical guidance.

Can someone receive vaccines while using secukinumab?

Many non-live vaccines may be appropriate, but vaccination plans should be reviewed with the prescribing clinician. Live vaccines are generally avoided during treatment, and it may be preferable to update certain vaccinations before treatment starts.

Can secukinumab be used if a person has inflammatory bowel disease?

A history of Crohn's disease or ulcerative colitis should be discussed carefully with the specialist. Secukinumab may worsen or newly trigger inflammatory bowel disease in some people, so new digestive symptoms need prompt medical review.

References

• U.S. Food and Drug Administration
• European Medicines Agency
• National Psoriasis Foundation
• American College of Rheumatology
• National Institute of Arthritis and Musculoskeletal and Skin Diseases

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.