2 The technology

Description of the technology

Secukinumab (Cosentyx, Novartis). It is a monoclonal antihuman antibody of the IgG1/kappa isotype that targets interleukin‑17A.

Marketing authorisation

Secukinumab has a marketing authorisation in the UK for the treatment of active ankylosing spondylitis 'in adults who have responded inadequately to conventional therapy'.

Adverse reactions

The overall incidence of treatment-emergent adverse events up to week 16 in the MEASURE 2 trial was comparable between the secukinumab 150‑mg group (65.3%) and the placebo group (63.5%). In MEASURE 1 there was a higher rate in the secukinumab 150‑mg group than with placebo (69.6% compared with 55.7%). There were no treatment-related deaths. For full details of adverse reactions and contraindications, see the summary of product characteristics.

Recommended dose and schedule

The recommended dose is 150 mg once weekly given by subcutaneous injection at weeks 0, 1, 2 and 3; followed by a maintenance dose once a month starting at week 4.

Price

Secukinumab is available at the list price of £609.39 for a 150‑mg pre-filled pen or syringe (excluding VAT, 'British national formulary' [BNF] July 2016). The company has agreed a patient access scheme with the Department of Health. This scheme provides a simple discount to the list price of secukinumab, with the discount applied at the point of purchase or invoice. The level of the discount is commercial in confidence. The Department of Health considered that this patient access scheme does not constitute an excessive administrative burden on the NHS.