Does Cosentyx Commonly Cause High Blood Pressure?
Cosentyx (secukinumab), an IL-17 inhibitor for psoriasis, psoriatic arthritis, and ankylosing spondylitis, lists hypertension as a possible side effect in its prescribing information, but it is not common. Clinical trials and post-marketing data show hypertension occurring in about 1-5% of patients, similar to or slightly above placebo rates, depending on the study and indication.[1][2]
How Often Does It Happen in Studies?
In pivotal trials like FUTURE 1-5 for psoriatic arthritis, hypertension was reported in 3-7% of Cosentyx users versus 2-5% on placebo. For plaque psoriasis (ERASURE/SCULPTURE trials), rates were around 1-2%, not exceeding placebo. Long-term extensions up to 5 years confirm no significant increase in incidence over time.[1][3] No dose-response pattern emerges, affecting subcutaneous or IV forms similarly.
Why Might It Happen and Who Is at Risk?
The mechanism is unclear—possibly linked to immune modulation or unmasking underlying conditions rather than direct vascular effects. Risks rise with pre-existing hypertension (up to 10% incidence), older age, obesity, or concurrent NSAIDs/steroids. Monitoring is advised quarterly for at-risk patients.[2][4]
What Do Patient Reports Say?
Real-world data from FAERS (FDA Adverse Event Reporting System) logs over 1,200 hypertension cases linked to Cosentyx since 2015, but crude rates remain low (<0.5% of total reports). Forums like Drugs.com and PatientsLikeMe show occasional complaints (e.g., "BP spiked after first dose"), often resolving with dose adjustment or antihypertensives, though causality is hard to prove amid comorbidities.[5]
Compared to Other Biologics
| Drug | Hypertension Rate (Trials) | Notes |
|------|----------------------------|-------|
| Cosentyx | 1-7% | Matches placebo closely |
| Humira (adalimumab) | 5-8% | Slightly higher |
| Stelara (ustekinumab) | 1-3% | Lowest among IL inhibitors |
| Tremfya (guselkumab) | 2-4% | Similar profile |
Cosentyx's rate is average for its class, lower than TNF inhibitors.[1][3]
What Should Patients Do?
Check blood pressure before starting and regularly thereafter. Report new or worsening hypertension to a doctor—discontinuation is rare but considered if severe. No black-box warning exists for this.[2]
Sources
[1]: Cosentyx Prescribing Information (Novartis)
[2]: FDA Label for Secukinumab
[3]: ClinicalTrials.gov summaries (NCT01695239, etc.)
[4]: Drugs.com Cosentyx Side Effects
[5]: FAERS Public Dashboard (FDA)]