Does Cosentyx Carry Pregnancy Risks?
Cosentyx (secukinumab), an IL-17A inhibitor for psoriasis, psoriatic arthritis, and ankylosing spondylitis, poses potential risks during pregnancy. Animal studies show no direct harm to fetuses at doses up to 48 times the human maximum, but it crosses the placenta in late pregnancy, potentially affecting fetal immune development. Human data is limited to registries and post-marketing reports, with no confirmed increased risk of major birth defects, miscarriage, or preterm birth, though small sample sizes limit conclusions. The manufacturer recommends avoiding use during pregnancy unless benefits outweigh risks, and effective contraception during treatment and for 20 weeks after the last dose.[1][2]
What Do Pregnancy Registries Show?
The Psoriasis Pregnancy Confirmation Cohort and other registries track outcomes in women exposed to Cosentyx. Early data from over 100 exposures report live birth rates around 80-90%, with miscarriage rates similar to the general population (10-15%). No clear pattern of congenital anomalies emerges, but monitoring continues due to the drug's immunomodulatory effects.[1][3]
Can It Affect Fertility or Breastfeeding?
No evidence links Cosentyx to male or female infertility. For breastfeeding, trace amounts appear in milk, but oral absorption by infants is low. The FDA assigns it Pregnancy Category B (no risk in animals, inadequate human data), advising caution during nursing.[2][4]
What If You're Planning Pregnancy or Already Pregnant?
Discontinue Cosentyx at least 20 weeks before trying to conceive due to its 22-30 day half-life. If exposed unintentionally, consult a doctor for ultrasound monitoring and consider enrolling in the Novartis Mother and Baby registry (1-877-311-8972). Alternatives like apremilast may have different profiles.[1][5]
How Does It Compare to Other Biologics in Pregnancy?
Unlike TNF inhibitors (e.g., adalimumab), which have more reassuring human data, Cosentyx has less real-world evidence. Etanercept shows slightly higher infection risks in exposed newborns, while ustekinumab has favorable registry data. All biologics warrant individualized risk assessment.[3][6]
Sources
[1] Cosentyx Prescribing Information, Novartis, novartis.com
[2] Drugs.com - Cosentyx Pregnancy Category
[3] Psoriasis Pregnancy Study, Journal of the American Academy of Dermatology
[4] FDA Drug Safety Communication on Biologics
[5] MotherToBaby Fact Sheet - Secukinumab
[6] Comparative Safety of Biologics in Pregnancy, JAMA Dermatology