Secukinumab is an anti IL 17A which has been approved by NICE for AS.
How it works
Secukinumab is a fully human monoclonal antibody. It works by neutralising the activity of a protein called IL 17A.
Research shows that people with AS have very high levels of IL 17A in their body compared with the general population. Researchers discovered that IL 17A plays a very important role in causing the inflammation associated with AS. By neutralising the IL 17A, secukinumab reduces inflammation in your body.
How to use it
Secukinumab is only available on prescription from a consultant rheumatologist.
It is taken by an injection under the skin using a special 'pen' device. You are shown how to do the injection by your rheumatologist or a nurse.
Secukinumb is a long term treatment. It starts with four 'loading doses'. After your first dose (week 0) you inject your medication weekly at weeks 1, 2 and 3. On week 4 you will receive the first of your monthly injections. After that you will continue to inject monthly.
It needs to be stored in your fridge in its box.
Time secukinumab takes to work
Like anti TNF therapy, secukinumab has a good response rate. The response rate is a little lower in people who have tried anti TNF and it has either not worked or the effect has reduced over time. This is in line with data on moving to a second anti TNF.
You may start to respond as early as the first week of treatment or it may take up to 16 weeks.
Possible side effects
Like all medicines, secukinumab may cause side effects. The most common side effects are:
- Upper respiratory tract infections
- Cold sores
- Runny nose
The advice for rheumatologists is to keep a much closer eye on people who also have Crohn's Disease and are being prescribed secukinumab. If you do have Crohn's or are being investigated for this condition then do make your rheumatologist aware. It's important because in clinical trials some patients with Crohn's suffered with exacerbations of their condition while they were taking secukinumab.
It can lower the immune system and so you may be more likely to develop infections. Avoid close contact with people with infections and contact your doctor or rheumatology nurse straight away if you develop any of the following symptoms:
- Fever, flu-like symptoms and night sweats
- Feeling unusually tired, short of breath or have a cough that won't go away
- Warm, red and painful skin or a painful skin rash with blisters
- Burning sensation when passing urine
In rare cases, people may have an allergic reaction to secukinumab.
If you're taking secukinumab it's recommended that you avoid live vaccines such as yellow fever or the shingles vaccine. If you do need a live vaccine do discuss all the possible risks and benefits of the vaccination with your doctor.
Secukinumab may be prescribed along with other medicines. Do discuss any new medications with your doctor before starting them, and always tell any doctor treating you that you are on secukinumab.
Secukinumab is not a painkiller. If you are already on anl anti inflammatory drug (NSAID) or painkillers you can carry on taking these as well as secukinumab, unless your doctor advises otherwise.
Do not take over-the-counter preparations or herbal remedies without discussing this first with your doctor, rheumatology nurse or pharmacist.
There is no known interaction between secukinumab and alcohol.
If you are going to have an operation please inform your doctor, as you are likely to be advised to stop the secukinumab temporarily before and after surgery.
You should not become pregnant whilst on secukinumab. If you are planning a family please make sure you talk about this with your rheumatology team.
If you are travelling abroad and taking secukinumab with you, it's important to make plans to keep it at the correct temperature during the journey and at your destination. You can buy special cool bags and even travel fridges. A useful company to try to purchase these products is MedActiv.
In addition to your secukinumab you may require a travel size sharps box. Do discuss this with your Clinical Nurse Specialist or your delivery team.
There's more travel tips in the `Living with AS` section of the website.
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