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Skyrizi vs Cosentyx
Introduction
For patients with moderate to severe plaque psoriasis, certain drugs that target specific proteins in your immune system can help reduce inflammation and slow the rapid growth of skin cells. Skyrizi and Cosentyx are two such drugs prescribed for this condition. They each impact different areas of the immune response but both have shown significant improvement in clearing plaques in patients with psoriasis.
Skyrizi is an interleukin-23 (IL-23) inhibitor whose role involves suppressing the inflammatory responses which contribute to symptoms of psoriasis by selectively binding to the p19 subunit of IL-23 cytokine and inhibiting its interaction with cell surface IL-23 receptors.
On the other hand, Cosentyx is a human IgG1 monoclonal antibody that selectively binds to the interleukin-17A (IL-17A) cytokine and inhibits its interaction with the IL-17 receptor, another critical part involved in inflammatory processes within our bodies. These treatments demonstrate how targeted immunotherapy can lead to improved patient outcomes.
Skyrizi vs Cosentyx Side By Side
| Attribute | Skyrizi | Cosentyx |
|---|---|---|
| Brand Name | Skyrizi | Cosentyx |
| Contraindications | Should not be taken if taking, have recently taken, or will soon receive a live vaccine. Special considerations for those with a history of tuberculosis (TB) or inflammatory bowel disease (IBD). | Should not be taken if taking, have recently taken, or will soon receive a live vaccine. Special considerations for those with a history of tuberculosis (TB) or inflammatory bowel disease (IBD). |
| Cost | Around $22,000 for two injections (150 mg/1mL) | Approximately $6,200 for one syringe (150mg/mL) |
| Generic Name | Risankizumab | Secukinumab |
| Most Serious Side Effect | Signs of a severe allergic reaction, upper respiratory infections, fungal skin infections, elevated liver enzymes indicating potential liver damage. | Signs of an allergic reaction, sickness symptoms such as fever, sweats or chills, cough with mucus and trouble breathing, sores in your mouth or on your skin, diarrhea with stomach pain, unusual tiredness, burning when you urinate or urinating more often than normal. |
| Severe Drug Interactions | Live vaccines due to immunosuppressive effects. | Live vaccines due to immunosuppressive effects. |
| Typical Dose | 150 mg as two subcutaneous injections every twelve weeks after an initial dose at week zero and another at week four. | 300 mg at weeks 0, 1, 2, 3, and 4 followed by a maintenance dosage of 300 mg once a month. |
What is Skyrizi?
Risankizumab (the generic name for Skyrizi) is a newer addition to the class of biologic medications, which has significantly evolved from the initial generation of psoriasis treatments. Skyrizi was first approved by the FDA in 2019. It works by selectively binding with interleukin-23, a naturally occurring cytokine that plays a key role in inflammatory processes, thus effectively inhibiting its interaction with the cell surface receptor. This mechanism results in less inflammation, helping manage symptoms of moderate-to-severe plaque psoriasis.
Secukinumab (the generic name for Cosentyx), another medication within this category but introduced earlier than Risankizumab and approved by FDA in 2015, operates slightly differently. It targets interleukin-17A directly to reduce skin inflammation.
Both drugs have been proven effective at clear or almost clear skin accomplishment during clinical trials; however they're not interchangeable as their targeted approach differs subtly leading to potential differences in side effects profile and response rate among patients.
What conditions is Skyrizi approved to treat?
Skyrizi and Cosentyx are both approved for the treatment of moderate to severe plaque psoriasis:
- Skyrizi is specifically approved for adults who are candidates for systemic therapy or phototherapy.
- Cosentyx, on the other hand, is also used in treating ankylosing spondylitis and psoriatic arthritis. It's suitable for patients who are candidates for systemic therapy or phototherapy and those who have not responded well enough to topical treatments or light therapy.
How does Skyrizi help with these illnesses?
Skyrizi works to manage moderate to severe plaque psoriasis by inhibiting the interleukin-23, a protein that plays a role in triggering inflammatory responses within the body. It does this by selectively binding and neutralizing interleukin-23, preventing it from acting on immune cells. This reduces inflammation and slows down skin cell production, which helps reduce symptoms of plaque psoriasis such as redness, thickness, and scaliness of lesions. Interleukins like IL-23 are cytokines that act as messengers between white blood cells and play an important role in mounting an immune response. However, when overactive or unregulated (as in autoimmune diseases like psoriasis), they can lead to excessive inflammation and damage tissues. Therefore by blocking interleukin-23, Skyrizi can limit the negative effects of excessive inflammation seen in conditions like plaque psoriasis helping patients manage their condition effectively.
What is Cosentyx?
Cosentyx, the brand name for secukinumab, is an interleukin inhibitor that works by blocking the action of interleukin-17A in the body. It was first approved by the FDA in 2015 for use in treating psoriasis and later expanded to include psoriatic arthritis and ankylosing spondylitis. Cosentyx operates differently from other medications because it specifically targets IL-17A, a type of protein that significantly contributes to inflammation when produced in excess amounts.
By targeting this particular protein instead of casting a wide net over various proteins related to immune response as many similar drugs do, Cosentyx can provide more focused treatment with potentially fewer side effects. Its distinct mechanism means its side-effect profile differs from those medications like Skyrizi (risankizumab), which inhibits interleukins-23 only. The specificity of Cosentyx's actions can be beneficial for patients who have not responded well or have experienced undesirable side effects with other therapies.
What conditions is Cosentyx approved to treat?
Cosentyx is a medication that is approved for the treatment of several conditions. These include:
- Moderate to severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy.
- Ankylosing spondylitis and psoriatic arthritis in adults, which can lead to joint damage and persistent musculoskeletal pain.
How does Cosentyx help with these illnesses?
Interleukin-17A is a type of protein that contributes to the inflammatory and immune responses in conditions like psoriasis. Cosentyx, by blocking this protein, helps control these reactions thereby alleviating some symptoms of psoriasis. It acts on specific cells and proteins involved in inflammation pathways, which also plays an important role in its efficacy as a treatment for psoriatic arthritis and ankylosing spondylitis. Unlike Skyrizi which targets interleukin-23 another pro-inflammatory protein but does not have proven effects against arthritic conditions associated with Psoriasis yet. Since Cosentyx significantly affects Interleukin-17A levels, it may be prescribed when a patient does not respond well to other biologic medications such as those targeting Interleukin 23 only (like Skyrizi), or maybe combined with them based on individual cases.
How effective are both Skyrizi and Cosentyx?
Both risankizumab (Skyrizi) and secukinumab (Cosentyx) have proven effectiveness in treating moderate to severe plaque psoriasis, with their approvals by the FDA only a few years apart. They function differently in their treatment approaches as they target different proteins involved in inflammation. The efficacy of Skyrizi and Cosentyx was analyzed in a 2020 head-to-head randomized clinical trial; both drugs demonstrated excellent performance controlling plaque psoriasis symptoms, while also maintaining promising safety profiles.
A review published the same year showed that patients treated with Skyrizi saw significant improvement within four weeks of starting therapy, indicating its rapid onset of action. It is generally well-tolerated even among diverse patient populations, including those who did not respond or were intolerant to other systemic therapies. Further studies have confirmed its long-term safety profile and durability of response over time.
On the other hand, according to data from several meta-analyses conducted between 2015 and 2018, Cosentyx consistently shows high rates of skin clearance when compared to placebo or etanercept—a TNF blocker commonly used for autoimmune diseases—and similar rates when compared with another IL-17 inhibitor called ixekizumab (Taltz). Although it's considered highly effective for most individuals suffering from moderate-to-severe plaque psoriasis, there are still some cases where Cosentyx may not be sufficient alone or tolerated due to side effects like diarrhea or upper respiratory tract infections. However, given its unique mechanism—targeting interleukin-17—it provides an alternative option for those not responding adequately to other treatments such as TNF blockers.
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At what dose is Skyrizi typically prescribed?
Dosages of Skyrizi for treating plaque psoriasis in adults often start at 150 mg, administered as two subcutaneous injections every twelve weeks after an initial dose at week zero and another one at week four. On the other hand, Cosentyx is typically prescribed at a dosage of 300 mg given as a subcutaneous injection each week for five weeks and then once a month thereafter. Both medications should be used under medical supervision and dosages may need to be adjusted based on individual response to treatment. Neither medication's maximum dosage should be exceeded without consultation from your healthcare provider.
At what dose is Cosentyx typically prescribed?
Typically, Cosentyx treatment is initiated with a loading dose of 300 mg at weeks 0, 1, 2, 3 and 4. This regimen can then be followed by a maintenance dosage of either one injection of the same strength every month or two injections spaced four weeks apart. The maximum dosage generally does not exceed this amount. If there is no adequate response to the medication after approximately five months (16 weeks) from the start date, your healthcare provider may reassess your treatment plan.
What are the most common side effects for Skyrizi?
Common side effects of Skyrizi include:
- Upper respiratory infections
- Fatigue (general weakness and fatigue)
- Headache
- Injection site reactions (like redness, itching, or pain at the injection site)
- Fungal skin infections.
Cosentyx users, on the other hand, may experience these common side effects:
- Diarrhea
- Cold symptoms (such as a runny nose or sore throat)
- Upper respiratory infections similar to the flu
- Skin rashes.
Both drugs can also potentially cause more serious side effects like severe allergic reactions and increased susceptibility to infection due to immune system suppression. It's vital for patients under these medications to report any unusual symptoms to their healthcare provider promptly.
Are there any potential serious side effects for Skyrizi?
While both Skyrizi and Cosentyx are considered safe medications for treating conditions such as psoriasis, they may cause serious side effects in rare cases. For Skyrizi, these could include:
- Signs of a severe allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat
- Upper respiratory infections including sinusitis and pharyngitis
- Fungal skin infections
- Elevated liver enzymes which might indicate damage to the liver cells
For Cosentyx the potential serious side effects can include:
- Signs of an infection - fever, flu symptoms, coughing up mucus or blood;
- Shortness of breath (even with mild exertion), swollen ankles or feet;
- Chest tightness/pressure/pain radiating from chest to jaw/left arm causing discomfort
- Lightheadedness leading to fainting spells
- Cold sores or blisters on your lip and in your mouth;
If you experience any signs of these side effects while taking either medication it is crucial that you seek medical attention immediately.
What are the most common side effects for Cosentyx?
There are a number of possible side effects that can occur when taking Cosentyx:
- Upper respiratory infections, including sore throat and stuffy nose
- Diarrhea
- Runny nose (rhinitis)
- Cold sores in the mouth or on the lips
- Mild rash
- Nausea
- Headache
- Fatigue It's important to note that while these side effects might sound alarming, they're usually mild and manageable. However, if any of them persist or worsen, be sure to seek medical attention promptly.
Are there any potential serious side effects for Cosentyx?
While Cosentyx is generally well-tolerated, like all medications it can cause side effects. These may include:
- Signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat
- Sickness symptoms such as fever, sweats or chills, cough with mucus and trouble breathing
- Sores in your mouth or on your skin
- Diarrhea with stomach pain that does not go away after a few days
- Unusual tiredness
- Burning when you urinate or urinating more often than normal
If any of these severe conditions develop while under the treatment of Cosentyx please consult with a healthcare professional immediately.
Contraindications for Skyrizi and Cosentyx?
Both Skyrizi and Cosentyx, along with most other medications for psoriasis or psoriatic arthritis, may increase the risk of infections. If you notice symptoms such as fever, cough, shortness of breath or other signs of an infection while using these drugs, please seek immediate medical attention.
Neither Skyrizi nor Cosentyx should be taken if you are taking, have recently taken or will soon receive a live vaccine. Always inform your physician which vaccinations you've received; live vaccines can cause serious complications in patients treated with either Skyrizi or Cosentyx due to their immunosuppressive effects.
Skyrizi and Cosentyx require special considerations if you have certain pre-existing conditions like tuberculosis (TB) or inflammatory bowel disease (IBD). In people who previously had TB but were not properly treated, both drugs might reactivate the disease. Similarly for IBD sufferers - these medicines could potentially worsen your condition. Before starting treatment with either drug it's important to discuss any past health issues.
How much do Skyrizi and Cosentyx cost?
For the brand name versions of these drugs:
- The price for two injections (150 mg/1mL) of Skyrizi averages around $22,000, which works out to about $367/day depending on your dosage schedule. Typically, Skyrizi is administered as two subcutaneous injections every twelve weeks after an initial dose at week zero and another at week four.
- The price for one syringe (150mg/mL) of Cosentyx is approximately $6,200, translating to roughly $207/day based on a typical monthly dosing regimen after an initial loading phase during the first five weeks.
Thus, if you are following a typical administration schedule for both medications with no insurance or patient assistance programs available to offset costs, then Cosentyx would be less expensive on a per-day treatment basis. However cost should not be a primary consideration in determining which drug is right for you - efficacy and side effect profiles must also be taken into account.
There are currently no generic versions available for either Skyrizi (risankizumab-rzaa) or Cosentyx (secukinumab), therefore prices generally remain high due to lack of competition.
Popularity of Skyrizi and Cosentyx
Risankizumab, known by the brand name Skyrizi, is a newer medication that was approved in 2019 for the treatment of moderate-to-severe plaque psoriasis. In its first year on the market, it gained significant traction due to its efficacy and convenience of dosing.
Secukinumab, available as Cosentyx, has been around since 2015 and has an established presence in treating psoriasis, psoriatic arthritis, and ankylosing spondylitis. It's estimated that over one million patients have been treated with Cosentyx worldwide as of 2020.
It’s important to note that both medications are part of a class called biologics: drugs derived from living cells used for therapeutic purposes. Both work by targeting specific proteins involved in inflammation processes; however they target different proteins - Skyrizi targets IL-23 while Cosentyx targets IL-17A. While both have proven effective for many patients struggling with inflammatory diseases such as psoriasis or arthritis conditions; their effectiveness can vary among individuals due not only to genetic factors but also disease severity and previous treatments history. As always before starting any new medication therapy potential side effects should be discussed thoroughly with your healthcare provider.
Conclusion
Both Skyrizi (risankizumab) and Cosentyx (secukinumab) have been established as effective treatments for moderate to severe plaque psoriasis, backed by numerous clinical studies demonstrating their efficacy over placebo treatments. They may be used in combination with other drugs, under careful consideration by a physician due to potential interactions. Skyrizi works primarily by inhibiting the interleukin-23 pathway, while Cosentyx acts on the interleukin-17A pathway.
Skyrizi is typically administered via subcutaneous injection once every 12 weeks after initial doses at week 0 and week 4. Cosentyx is also administered subcutaneously but requires weekly dosing for five weeks initially followed by monthly maintenance doses.
Both medications are available only under prescription, therefore cost can be significant especially for those who must pay out of pocket though patient assistance programs may help mitigate costs.
The side effect profiles of both drugs are similar with infections being most common; however, each drug has its own unique set of potential adverse effects which should be discussed with your healthcare provider prior to initiation of therapy. Patients using these medications will need regular monitoring particularly for signs of infection and should seek medical attention promptly if they notice any concerning symptoms.
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Refrences
- Warren, R. B., Blauvelt, A., Poulin, Y., Beeck, S., Kelly, M., Wu, T., … Paul, C. (2020, September 6). Efficacy and safety of risankizumab vs. secukinumab in patients with moderate‐to‐severe plaque psoriasis (IMMerge): results from a phase III, randomized, open‐label, efficacy–assessor‐blinded clinical trial*. British Journal of Dermatology. Oxford University Press (OUP).http://doi.org/10.1111/bjd.19341
- Crowley, J. J., Langley, R. G., Gordon, K. B., Pinter, A., Ferris, L. K., Rubant, S., … Warren, R. B. (2022, January 20). Efficacy of Risankizumab versus Secukinumab in Patients with Moderate-to-Severe Psoriasis: Subgroup Analysis from the IMMerge Study. Dermatology and Therapy. Springer Science and Business Media LLC.http://doi.org/10.1007/s13555-021-00679-6
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- Baronaite Hansen, R., & Kavanaugh, A. (2016, August 25). Secukinumab for the treatment of psoriatic arthritis. Expert Review of Clinical Immunology. Informa UK Limited.http://doi.org/10.1080/1744666x.2016.1224658
- Garnock-Jones, K. P. (2015, July 23). Secukinumab: A Review in Moderate to Severe Plaque Psoriasis. American Journal of Clinical Dermatology. Springer Science and Business Media LLC.http://doi.org/10.1007/s40257-015-0143-7
- Shirley, M., & Scott, L. J. (2016, June 14). Secukinumab: A Review in Psoriatic Arthritis. Drugs. Springer Science and Business Media LLC.http://doi.org/10.1007/s40265-016-0602-3
- Li, W., Ghamrawi, R., Haidari, W., & Feldman, S. R. (2019, October 31). Risankizumab for the Treatment of Moderate to Severe Plaque Psoriasis. Annals of Pharmacotherapy. SAGE Publications.http://doi.org/10.1177/1060028019885836