Does Cosentyx Reduce COVID-19 Vaccine Effectiveness?
Cosentyx (secukinumab), an IL-17 inhibitor for psoriasis and other autoimmune conditions, suppresses parts of the immune system that could blunt vaccine responses. Studies show it modestly reduces antibody production after COVID-19 vaccination, though T-cell responses often remain intact.[1][2]
A 2022 study in patients with psoriasis or psoriatic arthritis found that secukinumab users had lower anti-spike IgG levels 4-6 weeks after mRNA vaccination (Pfizer or Moderna) compared to healthy controls, but levels were still detectable and above seropositivity thresholds in most cases.[1] Neutralizing antibody titers were also lower, suggesting reduced protection against variants like Delta.[3]
Real-world data from Israel (2021) on 256 rheumatic disease patients confirmed weaker humoral responses in those on biologics like secukinumab versus non-biologic therapies.[2]
How Does It Compare to Other Biologics?
TNF inhibitors (e.g., Humira) and IL-23 inhibitors show similar or slightly less impact on vaccine antibodies than IL-17 blockers like Cosentyx. JAK inhibitors (e.g., Xeljanz) impair responses more severely. Unlike methotrexate, which strongly suppresses both B- and T-cell responses, Cosentyx primarily affects humoral immunity while preserving T-cell activation against SARS-CoV-2.[4][5]
| Drug Class | Antibody Response Reduction | T-Cell Impact |
|------------|------------------------------|---------------|
| IL-17 (Cosentyx) | Moderate | Minimal |
| TNF inhibitors | Moderate | Low |
| IL-23 inhibitors | Mild-moderate | Minimal |
| Methotrexate | High | High |
Should Patients on Cosentyx Get Boosters?
Guidelines from the American College of Rheumatology recommend COVID-19 vaccination for biologic users, including Cosentyx, with no need to pause therapy around doses. Boosters help overcome reduced responses, as seen in studies where third doses restored antibodies to protective levels.[6] Monitor for breakthrough infections, especially with variants.
What Do Patients Experience Post-Vaccination?
Breakthrough COVID cases occur but at rates similar to the general population when adjusted for comorbidities. No evidence links Cosentyx to higher severe outcomes post-vaccination; its immunomodulation may even lower cytokine storm risk in breakthrough infections.[7] Common patient concerns include fatigue and injection-site reactions, unchanged by Cosentyx.
Latest Data on Variants and Boosters
Omicron-specific studies (2023) show Cosentyx reduces neutralizing antibodies against BA.1/BA.5 more than against ancestral strains, but bivalent boosters mitigate this. A French cohort of 1,300+ patients found 80-90% seropositivity post-booster in IL-17 users.[3][8]
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9463663/
[2] https://ard.bmj.com/content/81/4/515
[3] https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(22)00294-5/fulltext
[4] https://www.rheumatology.org/Portals/0/Files/COVID-19-Vaccine-Clinical-Guidance-Rheumatic-Diseases-Summary.pdf
[5] https://www.nejm.org/doi/full/10.1056/NEJMoa2109169
[6] https://acrjournals.onlinelibrary.wiley.com/doi/10.1002/art.42096
[7] https://www.medrxiv.org/content/10.1101/2022.12.06.22283166v1
[8] https://link.springer.com/article/10.1007/s00296-023-05337-5