Ankylosing spondylitis (AS) is a type of arthritis featuring chronic inflammation of the sacroiliac joints and the spine. It mainly affects young adults and is more common in men than in women.
The most common symptom is a back pain in the morning and at night. Other signs and symptoms may include:
- reduced lung function;
- early morning stiffness;
- iron anemia;
- stooped shoulders;
- poor posture;
- weight loss;
- low-grade fever;
- loss of appetite.
In addition, the condition can cause pain, inflammation, and stiffness in other areas of the body, like – the hips, ribs, heels, shoulders, and small joints of the feet and hands. About 10 percent of people with AS experience symptoms so severe that they are at high risk of long-term disability.
- the formation of new bone;
- spinal compression fracture;
- anemia of inflammation;
- reduced lung capacity;
- heart inflammation;
- eye inflammation;
- bowel inflammation.
The exact cause of AS is unclear, but it is thought to be an autoimmune disease – where the body’s own immune system attacks the body’s tissues.
Psoriatic arthritis (PA) is a type of arthritis which affects some people who have psoriasis. It typically develops within 10 years of psoriasis being diagnosed.
It causes affected joints to become stiff, inflamed, and painful. This condition is more common among Caucasian people.
There are 5 types of psoriatic arthritis:
- arthritis mutilans;
- symmetric psoriatic arthritis;
- distal psoriatic arthritis;
- asymmetric psoriatic arthritis.
Symptoms of psoriatic arthritis may include:
- sausage-like swelling in fingers and/or toes;
- separation from the nail bed;
- reduced range of motion;
- pitting of the nails;
- morning stiffness;
- stiffness and pain in the neck and lower back.
PA occurs when the body’s immune system begins to attack healthy cells and tissue.
Some people with the condition may have too much of a protein called tumor necrosis factor, which contributes to inflammation in the joints.
Here is a comparison between Cosentyx and Enbrel, two medications that can relieve symptoms and may keep these diseases from getting worse.
Cosentyx is a subcutaneous injection (with sites usually in the thighs, upper arms, and stomach) which contains secukinumab – a medication which belongs to the family of medications called biological response modifiers (“biologics”).
Enbrel (etanercept) belongs to the family of medications called tumor necrosis factor inhibitors or biological response modifiers.
Cosentyx is used to treat adults with ankylosing spondylitis, moderate-to-severe plaque psoriasis, and psoriatic arthritis.
Enbrel is used to treat:
- plaque psoriasis in adults and children who are at least 4 years old;
- polyarticular juvenile idiopathic arthritis in children who are at least 2 years old;
- ankylosing spondylitis;
- psoriatic arthritis;
- rheumatoid arthritis.
Cosentyx works by regulating the body’s inflammatory response and blocking the action of a protein called interleukin-17A.
Enbrel works by decreasing a protein produced by the immune system to help the body fight infections.
Possible side effects of Cosentyx include:
- skin rash, hives. or itching;
- chest tightness;
- muscle aches;
- difficulty swallowing;
- runny nose;
- rectal bleeding;
- unusual weakness;
- eyelid puffiness;
- ear congestion;
- increased heart rate;
- skin redness;
- difficulty breathing;
- loss of voice.
Possible side effects of Enbrel include:
- redness or swelling at the site of injection;
- yellowing of the skin or eyes (jaundice);
- stomach pain;
- clay-colored bowel movements;
- dark urine;
- swelling of the tongue, throat, arms, hands, face, eyes, lips, feet, ankles, or lower legs;
- rash on the face and arms which worsens in the sun;
- bruising or bleeding;
- scaly, patches or pus-filled bumps on the skin;
- weakness in the arms or legs;
- pale skin;
- blistering skin;
- vision problems;
- difficulty swallowing or breathing;
- loss of appetite;
- excessive tiredness.
The first 4 doses of Cosentyx are typically given once per week. After, the drug is given once every 4 weeks.
The usual recommended dose of Enbrel for psoriatic arthritis, rheumatoid arthritis, or ankylosing spondylitis is 50 mg every week.
Warnings & Precautions
To make sure Cosentyx is safe for you, tell your healthcare professional if you have:
- Crohn’s disease;
- an active infection.
People who take Enbrel are at an increased risk of developing bacterial, viral, or fungal infections. Also, before taking this biological response modifier, you should tell your healthcare professional if you have or have ever had the following:
- heart failure;
- liver disease;
- any cuts or open sores;
- bleeding problems;
- any disease which affects the nervous system, like – Guillain-Barre syndrome or multiple sclerosis;
- optic neuritis;
- transverse myelitis.
Cosentyx may interact in a negative way with the following medications:
- Alfentanil (a potent but short-acting synthetic opioid analgesic drug);
- Aminophylline (a drug that is used to prevent and treat shortness of breath, wheezing, and difficulty breathing);
- Cyclosporine (an immunosuppressant medication);
Enbrel may interact in a negative way with the following medications:
- prednisone (a synthetic glucocorticoid drug which is used to suppress the immune system);
- amlodipine (a medication used to treat high blood pressure);
- Plaquenil (hydroxychloroquine);
- methotrexate (a chemotherapy agent that is used to treat cancer);
- Humira (adalimumab).
Do not consume alcohol while taking these drugs since alcohol may increase the risk of adverse effects.
Is It Safe During Pregnancy or Breastfeeding?
Both drugs should only be used in pregnant women when there is a clear need. Moreover, due to the risk of serious side effects in the breastfed babies, a decision should be made whether to discontinue Enbrel or nursing.
Final Words – Cosentyx vs Enbrel
Cosentyx (secukinumab) is used to treat ankylosing spondylitis, moderate to severe plaque psoriasis, and psoriatic arthritis in adults. This immunosuppressant medication works by reducing the effects of a chemical substance in the human body which can cause inflammation.
Enbrel (etanercept) is an injectable medication which is used for treating ankylosing spondylitis, rheumatoid arthritis, plaque psoriasis, and psoriatic arthritis. Etanercept is in a class of medications known as tumor necrosis factor (TNF) inhibitors and works by blocking tumor necrosis factor alpha (TNF alpha).
In conclusion, both drugs are effective in treating ankylosing spondylitis and psoriatic arthritis symptoms but they have different active ingredients and mechanisms of action.
Sources https://www.novartis.com/news/media-releases/novartis-new https://www.sciencedirect.com/science/article/pii/S0190962215016837 https://www.ncbi.nlm.nih.gov/pubmed/28417318 http://clincancerres.aacrjournals.org/content/10/19/6528