Cosentyx (secukinumab) and Stelara (ustekinumab) are prescription medications used to treat plaque psoriasis and psoriatic arthritis, as well as certain other inflammatory conditions. These drugs are biologics.
Cosentyx and Stelara are both brand-name drugs. Neither is currently available in biosimilar form. (A biosimilar is a medication that’s similar to a brand-name biologic drug.)
This article highlights the key differences between Cosentyx and Stelara. This information may help you and your doctor consider whether Cosentyx or Stelara may be right for you.
Cosentyx contains secukinumab. Stelara contains ustekinumab.
Both of these medications are a type of drug called a monoclonal antibody. Secukinumab and ustekinumab each block a different part of the immune system that’s overactive with plaque psoriasis and psoriatic arthritis. In this way, the drugs help to control the symptoms of these conditions.
Cosentyx and Stelara have been approved by the Food and Drug Administration (FDA) to treat several conditions.
- Both Cosentyx and Stelara are approved to treat:
- moderate to severe plaque psoriasis in adults and children ages 6 years and older who may need phototherapy or systemic therapy (treatment that works throughout the body)
- active* psoriatic arthritis in adults
- Cosentyx is also FDA-approved to treat:
- active psoriatic arthritis in children ages 2 years and older
- active enthesitis-related arthritis (a form of arthritis in which there’s inflammation in the entheses, which are areas on your bones where tendons and ligaments attach) in adults and children ages 4 years and older
- active non-radiographic axial spondyloarthritis (inflammation in the spine or pelvis that doesn’t show up on X-rays) in adults with signs of inflammation in blood tests or MRI scans
- ankylosing spondylitis in adults
- Stelara is also FDA-approved to treat:
- moderately to severely active Crohn’s disease in adults
- moderately to severely active ulcerative colitis in adults
* “Active” means that you currently have symptoms.
Cosentyx or Stelara and children
Cosentyx and Stelara have certain approved uses in children.
Specifically, both drugs are approved for use in children ages 6 years and older with moderate to severe plaque psoriasis.
In addition, Cosentyx is approved for use in children ages:
- 4 years and older with active enthesitis-related arthritis
- 2 years and older with active psoriatic arthritis
How much Cosentyx or Stelara costs depends on the treatment plan your doctor prescribes, your insurance plan, and your pharmacy.
Both Cosentyx and Stelara are brand-name drugs. Neither drug is currently available in biosimilar form. (A biosimilar is a medication that’s similar to a brand-name biologic drug.) Biosimilars also usually cost less than brand-name drugs.
Here are answers to some frequently asked questions about Cosentyx and Stelara.
Do Cosentyx and Stelara cause hair loss?
If you have hair loss during treatment with Stelara or Cosentyx, talk with your doctor. They’ll check to see if you have other health conditions that may be causing your hair loss. They can also describe ways to help reduce your hair loss.
Do Cosentyx and Stelara work differently?
Yes, these drugs do work in slightly different ways. They’re both biologic treatments. And they both reduce overactivity in your immune system (your body’s defense against disease). Both drugs reduce the inflammation that causes symptoms of plaque psoriasis and psoriatic arthritis. But they do this by working on different proteins produced by your immune system.
Cosentyx blocks a protein called interleukin 17-A. Stelara blocks two proteins called interleukin 12 and interleukin 23. Because they work in slightly different ways, one drug may work for you if the other doesn’t.
Cosentyx contains the drug secukinumab. Stelara contains the drug ustekinumab. Dosage for either drug will depend on the treatment plan your doctor prescribes for you.
Forms and administration for Cosentyx
Cosentyx comes in three forms. Each form contains 150 milligrams/milliliter (mg/mL) of the drug:
- liquid solution in a single-use Sensoready pen
- liquid solution in a single-use prefilled syringe
- powder in a single-use vial*
* Only a healthcare professional can give you the medication in this form. They’ll mix the powder with a solution and give you the injection.
Cosentyx is given as a subcutaneous injection. At first, your healthcare professional will give you either injection. They can train you to do the injections yourself, after which you’ll be able to give yourself injections at home with a Sensoready pen or syringe.
For plaque psoriasis in adults and children: You’ll have two injections every week for 5 weeks. After 5 weeks, you’ll have two injections once every 4 weeks.
For psoriatic arthritis in adults: Depending on how severe your condition is, your doctor may give you a loading dose. This is a higher dose of medication at the beginning of treatment so that the drug can start working more quickly. You’ll have an injection once a week for 5 weeks. After 5 weeks, you would need an injection once every 4 weeks.
If your doctor doesn’t think that a loading dose is the right option, you can start with an injection once every 4 weeks.
For adults with both plaque psoriasis and psoriatic arthritis: You’ll have the same dosage as if you just have plaque psoriasis. See above for details.
* This form of Stelara is only used to give the first dose of the drug to people with Crohn’s disease or ulcerative colitis. This first dose is given by IV infusion (an injection into your vein that’s given over a period of time). After this first dose, additional doses of Stelara are given by subcutaneous injection.
Stelara is also given as a subcutaneous injection. For adults, your healthcare professional will give you the injection at first. They can train you to do the injections yourself, after which you’ll be able to give yourself injections at home. However, children should get all their Stelara injections from a healthcare professional.
The dose of Stelara that you take will be based on your weight and the condition you’re taking it for.
For plaque psoriasis in adults and children: You’ll have a starting dose, followed by another injection 4 weeks later. Then you’ll have an injection every 12 weeks.
For psoriatic arthritis in adults: You’ll have a starting dose, followed by another injection 4 weeks later. Then you’ll have an injection every 12 weeks.
For adults with both plaque psoriasis and psoriatic arthritis: You’ll have a starting dose, followed by another injection 4 weeks later. Then you’ll have an injection every 12 weeks.
Cosentyx and Stelara contain different drugs, but they work in a similar way. Because of this, these drugs can cause some of the same side effects, as well as some different ones. Examples of these side effects are given below.
Mild side effects
The following lists address some of the mild side effects of Cosentyx or Stelara, and some that both drugs share. For more information on mild side effects of the two drugs, see the prescribing information for Cosentyx and Stelara.
- Can occur with Cosentyx:
- cold sores
- Can occur with Stelara:
- feeling tired
- muscle pain
- redness at your injection site
- Can occur with both Cosentyx and Stelara:
- minor respiratory infections, such as the common cold
Serious side effects
The following lists address the serious side effects of Cosentyx or Stelara, and ones that both drugs share.
- Can occur with Cosentyx:
- Can occur with Stelara:
- a rare brain condition called reversible posterior leukoencephalopathy syndrome (RPLS)
- Can occur with both Cosentyx and Stelara:
- serious allergic reactions
Cosentyx and Stelara have different FDA-approved uses, but they’re both used to treat moderate to severe plaque psoriasis and psoriatic arthritis in adults. Both drugs have been found to be effective for these conditions.
Cosentyx and Stelara share some of the same warnings, but they also have different ones. Some of these warnings are mentioned below. Before you start using Cosentyx or Stelara, be sure to talk with your doctor to see if these warnings apply to you.
Warnings for Cosentyx and Stelara include:
- Infections including tuberculosis. Both of these drugs can weaken your immune system (your body’s defense against infection). This can raise your risk for getting infections and worsen any infections you already have. It can also cause a flare-up of infections you may have had in the past, including tuberculosis (TB). Your doctor will test you for TB before you start taking Cosentyx or Stelara. If you have active TB or have had TB in the past, you may need treatment for this before you can start either of these medications. If you have any other active infection, you may need treatment for this before you can start either of these medications.
- Allergy to latex. If you’re allergic to latex, you may not be able to use certain forms of Cosentyx or Stelara. The cap on the Cosentyx Sensoready pen and prefilled syringe contains latex. The needle cover on Stelara prefilled syringes also contains latex. If you’ve ever had an allergic reaction to latex, talk with your doctor about which forms of these drugs are safe for you.
- Pregnancy and breastfeeding. It’s not known if Cosentyx or Stelara are safe to take during pregnancy or while breastfeeding. If you’re pregnant or breastfeeding, talk with your doctor before taking either of these drugs.
Other warnings for Cosentyx include:
- Inflammatory bowel disease. Cosentyx can worsen symptoms of inflammatory bowel disease (IBD). If you have IBD, you may need extra monitoring while you’re taking Cosentyx. Talk with your doctor about whether Cosentyx is safe for you.
Other warnings for Stelara include:
- Cancer. Stelara can make your immune system less able to kill cancer cells. If you’ve ever been diagnosed with cancer, talk with your doctor about whether Stelara is safe for you.
Cosentyx and Stelara won’t work for everyone. And sometimes these drugs can stop working for you after you’ve taken them for a long time. However, it’s possible to switch treatment from Cosentyx to Stelara or vice versa.
These drugs work in slightly different ways, so if one drug doesn’t help your condition, the other might. Switching treatment might also be an option if you have bothersome side effects from one of these drugs.
How you switch treatment depends on several factors. These include the reason for switching and how severe your symptoms are. Your doctor may simply change you over to the new treatment when your next dose is due. Or they may ask you to wait until the drug is fully removed from your system before you start taking the new drug.
If you’re interested in switching from Cosentyx to Stelara or vice versa, talk with your doctor. They can recommend if switching treatment is the right option for you. They can also explain how this would be done in your personal situation.
Note: Never switch treatments without your doctor’s approval and guidance.
Key factors to consider when comparing these drugs include the following:
- With long-term treatment, Cosentyx needs to be taken every 4 weeks. On the other hand, Stelara can be taken every 12 weeks.
- Your health history might be a factor to consider. For example, if you have inflammatory bowel disease, Cosentyx could make this disease worse. However, Stelara can actually treat this condition.
If you’d like to learn more about Cosentyx or Stelara, talk with your doctor or pharmacist. Discuss the information in this article as well as your full health history. They can help answer any questions you may have about these drugs. And they can help you decide if Cosentyx, Stelara, or another medication may be right for you.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.