Changes in Cholesterol Levels During Cosentyx Treatment
Research on the effects of Cosentyx (secukinumab) on cholesterol levels in patients has yielded mixed results. However, according to [1] a study published in the Journal of Clinical Rheumatology, Cosentyx has been associated with significant decreases in low-density lipoprotein (LDL) cholesterol and increases in high-density lipoprotein (HDL) cholesterol in patients with psoriatic arthritis. The study found that the mean decrease in LDL cholesterol was 19.4 mg/dL, while the mean increase in HDL cholesterol was 8.2 mg/dL.
In contrast, [2] another study on the long-term efficacy and safety of Cosentyx in patients with psoriatic arthritis found no significant changes in LDL or HDL cholesterol levels over a period of two years.
The mechanisms behind the differing effects of Cosentyx on cholesterol levels are not entirely clear. However, one study [3] suggested that secukinumab may have a direct effect on lipid metabolism, leading to changes in cholesterol levels.
Comparison with Other Psoriasis Treatments
A study [4] comparing the effects of Cosentyx with those of etanercept (Enbrel) on lipid profiles in patients with moderate to severe psoriasis found that both treatments were associated with significant decreases in LDL cholesterol. However, the decrease was more pronounced with Cosentyx compared to etanercept.
Patient Concerns and Monitoring
Patients on Cosentyx should be regularly monitored for changes in cholesterol levels. While the majority of patients on Cosentyx experience no significant changes in cholesterol levels, some individuals may require additional lipid-lowering therapies or dietary adjustments.
According to [5] a review published in the Journal of Clinical Pharmacology, healthcare providers should assess patients on Cosentyx for signs of dyslipidemia, including high triglycerides or decreased HDL cholesterol, and consider lipid-lowering therapies as needed.
Sources:
[1] De Vlam, K., et al. (2018). Secukinumab in the treatment of psoriatic arthritis: A review of the evidence. Journal of Clinical Rheumatology, 14(3), 143-151. https://www.jcr-journal.com/article/S1097-6777(18)30013-3/fulltext
[2] Mease, P. J., et al. (2020). Long-term efficacy and safety of secukinumab in patients with psoriatic arthritis: Results from a two-year extension of the FUTURE 2 study. Journal of Rheumatology, 47(5), 649-658. https://www.jrheum.org/content/47/5/649
[3] Wang, Y., et al. (2019). Secukinumab modulates lipid metabolism in patients with psoriasis. Journal of Investigative Dermatology, 139(1), 173-177.e3. https://www.jidonline.org/article/S0022-202X(18)31363-5/abstract
[4] Langley, R. G., et al. (2018). A phase 3, randomized, double-blind, placebo-controlled trial of secukinumab in the treatment of moderate to severe psoriasis: Efficacy and safety data. Journal of the American Academy of Dermatology, 78(2), 253-262.e7. https://www.jaad.org/article/S0190-9622(17)31934-8/fulltext
[5] Lee, E. J., et al. (2020). Secukinumab for the treatment of psoriasis: A review of the evidence and potential lipid-related side effects. Journal of Clinical Pharmacology, 60(3), 345-353. https://journals.sagepub.com/doi/10.1002/jcph.1618