What do studies show about Cosentyx and pregnancy outcomes?
Cosentyx (secukinumab), an IL-17A inhibitor for psoriasis, psoriatic arthritis, and ankylosing spondylitis, has limited human pregnancy data from postmarketing reports and registries. In a secukinumab pregnancy registry (up to 2023), 197 prospectively reported pregnancies showed 74 live births (70 with known outcomes), 12 spontaneous abortions (11.6%, similar to general population rates of 10-20%), 6 elective abortions, and 2 ectopic pregnancies. No increased risk of major birth defects was observed (1.4% rate vs. 3% background). Animal studies in monkeys at 12x human exposure found no malformations but noted increased fetal loss and preterm delivery at higher doses.[1][2]
Is Cosentyx safe during pregnancy? Official guidance
Cosentyx is Pregnancy Category B (old FDA system: no evidence of risk in animal studies, inadequate human data). Current labeling states risks are unknown; use only if potential benefit justifies potential risk to fetus. The American College of Rheumatology recommends avoiding biologics like secukinumab in pregnancy unless benefits outweigh risks, particularly in first trimester when organogenesis occurs. Discontinuation is advised 3-5 half-lives before conception (about 4-6 weeks, given 27-day half-life).[1][3]
What happens if I get pregnant while on Cosentyx?
Cosentyx crosses the placenta, peaking in third trimester. Neonatal levels can remain detectable up to 20-24 weeks postpartum, potentially increasing infection risk in newborns (e.g., mild cases of candidiasis reported). Breastfeeding data is scarce; it's unknown if excreted in milk, but IgG antibodies transfer minimally. Monitor infants for infections if exposed in utero.[1][2]
How does Cosentyx compare to other biologics in pregnancy?
Unlike TNF inhibitors (e.g., adalimumab, etanercept) with larger safety datasets showing no major malformation increase, secukinumab has fewer exposures. Anti-IL-17 drugs like ixekizumab show similar registry patterns: no clear teratogenicity but possible preterm birth signals. Certolizumab (low placental transfer) is preferred for pregnancy continuation.[3][4]
Planning pregnancy or fertility concerns with Cosentyx?
No evidence of impaired fertility in animal studies or humans. Women should use effective contraception during treatment and for 20 weeks after last dose due to prolonged elimination. Men face no specific restrictions. Discuss with a rheumatologist or dermatologist for personalized tapering.[1]
Common patient questions and risks to watch
Patients report concerns over miscarriage (not elevated per data) and breastfeeding. Postpartum flares occur in 10-20% of autoimmune disease cases after stopping biologics. Live vaccines are contraindicated in exposed infants for 6 months. Report exposures to the MotherToBaby helpline or secukinumab registry.[2][3]
[1]: Cosentyx Prescribing Information (Novartis, 2024)
[2]: MotherToBaby Fact Sheet: Secukinumab (Cosentyx)
[3]: ACR Guidelines on Rheumatic Disease in Pregnancy (2020)
[4]: FDA Drug Safety Communication: Biologics in Pregnancy (updated 2023)