Does Cosentyx (secukinumab) require heart tests before starting?
Cosentyx is not known for a standard “must-do first” heart testing requirement in routine prescribing. The decision usually focuses on your medical history and the kind of heart-related risk you already have.
That said, because Cosentyx can affect immune activity, clinicians often look for overall safety issues (including infection risk) rather than ordering a specific heart scan or stress test for everyone.
What heart-related checks might a clinician do before prescribing?
If you have symptoms or known heart conditions, your clinician may choose additional evaluation before or alongside starting any biologic therapy, including Cosentyx. Examples of situations where people commonly get cardiac workup include:
- Known heart failure or previous heart rhythm problems
- Active chest pain, fainting, or unexplained shortness of breath
- A recent hospitalization for a cardiac issue
- Strong personal or family history of significant cardiovascular disease
In these cases, the clinician may request tests such as an ECG and basic bloodwork, and they may coordinate with cardiology depending on what’s already going on medically.
Are routine echocardiograms or stress tests required?
Routine echocardiograms, stress tests, or cardiac monitoring are generally not required for every patient solely because they’re starting Cosentyx. They’re typically ordered only if you have a reason to investigate cardiac status (symptoms or known disease).
What symptoms should trigger a heart-focused check before or during treatment?
You should contact your clinician promptly if you develop new or worsening:
- Chest pain or pressure
- Shortness of breath at rest or with minimal exertion
- Fainting or near-fainting
- Fast, irregular heartbeat
- New swelling in the legs/ankles (especially if worsening)
What other pre-treatment screening is commonly done with Cosentyx?
Even when there’s no special heart testing, clinicians commonly do infectious disease screening before starting biologics, because immunomodulating medicines can increase risk from certain infections.
Common examples include checking for tuberculosis before biologic use and reviewing your history for other infections.
If you tell me your situation, I can be more specific
Heart testing needs depend heavily on your history. If you share:
- your age
- what you’re being treated for (psoriasis, psoriatic arthritis, ankylosing spondylitis, etc.)
- any known heart diagnoses (heart failure, arrhythmia, prior heart attack)
- whether you have symptoms (shortness of breath, chest pain, palpitations)
I can help you understand what questions to ask your prescriber about whether any ECG/echo or cardiology review is warranted.