Novartis announced that the U.S. Food and Drug Administration (FDA) has approved Cosentyx (secukinumab) for the treatment of moderate to severe hidradenitis suppurativa (HS) in adults. This marks a significant advancement as Cosentyx is the first new biologic treatment option for HS patients in nearly a decade.
Cosentyx is a fully human biologic that directly inhibits interleukin-17A (IL-17A), a cytokine involved in the inflammation associated with HS. The approval is based on data from the Phase III SUNSHINE and SUNRISE trials, the largest Phase III program in HS to date.
Clinical Trial Data
The SUNSHINE and SUNRISE trials were identical, global Phase III, multicenter, randomized, double-blind, placebo-controlled, parallel-group studies. These trials evaluated the efficacy, safety, and tolerability of two dose regimens of Cosentyx in adults with moderate to severe HS over 16-week and 52-week treatment periods. The primary endpoint was the Hidradenitis Suppurativa Clinical Response (HiSCR50), defined as at least a 50% decrease in abscess and inflammatory nodule (AN) count with no increase in the number of abscesses and/or draining tunnels.
Results from the trials showed that a significantly higher proportion of patients achieved HiSCR50 when treated with Cosentyx 300 mg dosed every two weeks (after standard weekly loading doses) compared to placebo in both the SUNSHINE (44.5% vs 29.4%, P<0.05) and SUNRISE (38.3% vs 26.1%, P<0.05) trials. Additionally, a greater proportion of patients randomized to Cosentyx 300 mg dosed every four weeks (after standard weekly loading doses) achieved HiSCR50 compared with placebo in both SUNSHINE (41.3% vs 29.4%) and SUNRISE (42.5% vs 26.1%, P<0.05) trials.
Dosing and Administration
Cosentyx is approved for HS as a 300 mg dose, administered every four weeks, with the option to increase to every two weeks if the patient has an inadequate response.
Impact on Patients
Hidradenitis suppurativa is a chronic, systemic, and often painful skin disease characterized by recurring boil-like lumps that may burst into open wounds and cause irreversible scarring. It is estimated that HS affects approximately 1 in 100 people worldwide, and it can take up to 10 years for patients to receive a correct diagnosis. This delay can result in disease progression and significantly impact their quality of life.
Alexa B. Kimball, MD, MPH, lead investigator of the SUNSHINE and SUNRISE trials, noted, "For many patients, the daily impact of HS and the search for symptom relief can last years – which can come with painful, irreversible physical and emotional scarring. This approval marks an important milestone for countless patients who have been faced with limited treatment possibilities and who now have a new option."
Donna Atherton, EdD, Founder and Chief Mission Officer of the International Association of Hidradenitis Suppurativa Network (IAHSN), added, "The approval of a new treatment option brings fresh hope to me and the HS community that we may find relief from the burden of the disease."
About Cosentyx
Cosentyx is the first and only fully human biologic that specifically targets and blocks interleukin-17A (IL-17A). It is already approved for the treatment of psoriatic arthritis (PsA), moderate to severe plaque psoriasis, ankylosing spondylitis (AS), and non-radiographic axial spondyloarthritis (nr-axSpA).
