Does Cosentyx Increase Infection Risk?
Yes, Cosentyx (secukinumab) increases susceptibility to infections. It blocks interleukin-17A (IL-17A), a cytokine that helps fight infections, particularly fungal and bacterial ones. Clinical trials and post-marketing data show higher infection rates in patients taking it compared to placebo.[1][2]
Patients on Cosentyx had upper respiratory tract infections in 14-19% of cases versus 12-14% on placebo. Serious infections occurred in about 1-2% of treated patients, including tuberculosis reactivation and invasive fungal infections like candidiasis.[2][3]
What Infections Are Most Common?
Common infections include nasopharyngitis, upper respiratory infections, and bronchitis. Oral herpes and tinea infections also rise due to IL-17's role in mucosal immunity.[2]
Serious cases involve pneumonia, cellulitis, and sepsis, though rates stay below 3% in trials. Crohn's disease patients face higher risks of upper GI infections.[3][4]
How Does It Compare to Other Biologics?
Cosentyx shows similar or slightly lower serious infection rates than TNF inhibitors like Humira (adalimumab) or Enbrel (etanercept), where rates hit 3-5%. Versus IL-23 inhibitors like Tremfya (guselkumab), infection profiles align closely, but Cosentyx has more candidiasis reports.[4][5]
| Drug | Serious Infection Rate (per 100 patient-years) |
|------|-----------------------------------------------|
| Cosentyx | 2.9-4.1 [2] |
| Humira | 3.8-8.5 [5] |
| Stelara (ustekinumab) | 2.8-4.7 [4] |
Who Faces Higher Risks?
Elderly patients, those with comorbidities like diabetes or COPD, or prior infections have elevated risks. Concomitant steroids or live vaccines amplify susceptibility—avoid live vaccines entirely.[1][3]
TB screening is required before starting, with 0.1-0.4% reactivation rates in screened populations.[2]
What Do Prescribers and Labels Say?
The FDA label warns of increased infection risk, mandating monitoring for signs like fever or cough. Discontinue if serious infection develops. No black box warning, unlike some TNF blockers.[1]
Patient reports on forums note more colds and shingles, though trials underreport mild cases.[6]
How to Manage Risks on Cosentyx?
Screen for latent TB and hepatitis. Use prophylaxis for at-risk patients. Promptly treat infections; hold doses during active ones. Long-term data (up to 5 years) confirm risks don't escalate over time.[3][7]
[1]: FDA Cosentyx Label
[2]: Langley RG et al., N Engl J Med 2014;371:326-38
[3]: Novartis Cosentyx PI, 2023
[4]: Gordon KB et al., Lancet 2015;386:251-61
[5]: Papp K et al., J Am Acad Dermatol 2017;76:70-80
[6]: DrugPatentWatch.com (Cosentyx adverse events summary)
[7]: Bissonnette R et al., J Eur Acad Dermatol Venereol 2018;32:661-70