Does Cosentyx Weaken COVID-19 Vaccine Response?
Cosentyx (secukinumab), an IL-17A inhibitor used for psoriasis, psoriatic arthritis, and ankylosing spondylitis, modestly reduces immune responses to COVID-19 vaccines. In a phase 4 trial of 250 patients, seroconversion rates after two doses of mRNA-1273 (Moderna) were 89% for Cosentyx users versus 100% for non-users, with geometric mean titers (GMT) 1.6-fold lower in Cosentyx patients (95% CI: 1.2-2.2). T-cell responses were preserved.[1]
How Was This Measured?
Antibody levels were assessed via Elecsys Anti-SARS-CoV-2 S assay at baseline, day 29, and day 169 post-vaccination. Neutralizing antibodies against wild-type and variants (Alpha, Beta, Delta) showed similar trends: Cosentyx reduced titers by 1.3- to 2.1-fold. Despite this, most patients achieved protective thresholds, and no severe COVID-19 cases occurred during 6-month follow-up.[1]
Impact on Boosters and Variants?
Booster data is limited, but a smaller study on BNT162b2 (Pfizer) boosters in IL-17/23 inhibitor users (including Cosentyx) found GMTs 1.5-fold lower than healthy controls, with adequate neutralization against Omicron BA.1.[2] Real-world evidence suggests Cosentyx does not abolish protection; breakthrough infections occur but are typically mild.[3]
Should Patients Skip or Delay Dosing?
Guidelines from the National Psoriasis Foundation and ACR recommend vaccinating without interrupting Cosentyx, as benefits outweigh modest immunogenicity risks. No excess severe COVID-19 or infections reported in vaccinated Cosentyx users versus unvaccinated.[1][4] Delaying doses around vaccination lacks strong evidence and risks disease flares.
Comparisons to Other Biologics
| Biologic Class | Vaccine Antibody Reduction | Notes |
|---------------|----------------------------|-------|
| TNF inhibitors (e.g., Humira) | 2-4 fold lower GMT | Strongest impact[5] |
| IL-17/23 inhibitors (e.g., Cosentyx, Skyrizi) | 1.5-2 fold lower GMT | Milder effect; T-cells intact[1][2] |
| IL-23 inhibitors (e.g., Tremfya) | Minimal/no reduction | Least impact[6] |
| JAK inhibitors (e.g., Xeljanz) | Variable, up to 3-fold | Higher infection risk overall[5] |
Cosentyx's effect is intermediate, better than TNFs but worse than some IL-23s.
What Do Patients Experience?
Breakthrough infections in Cosentyx users post-vaccination are rare and mild, per registries like Psoriasis Patient Registry. No data links Cosentyx to vaccine failure or long COVID specifically. Monitor symptoms; consult rheumatologists for personalized risk.[3][4]
[1]: Rheumatology (Oxford) - Secukinumab and COVID-19 vaccine response
[2]: JAMA Dermatol - Biologics and Omicron boosters
[3]: J Am Acad Dermatol - Psoriasis registries
[4]: ACR Guidelines - Vaccinations in rheumatic diseases
[5]: Lancet Rheumatol - Meta-analysis of biologics
[6]: Br J Dermatol - IL-23 inhibitors