Psorasias returns after 1 year Cosentyx, Can i Reload?

[FRP88]

Hi All,

Just a few weeks i ago i was so optimistic with my Cosentyx treatment that i started a topic on whether or not i could reduce dosage from 300mg to 150mg per month.
I asked this here because i am using this under no supervision. (No biologics available in my country, local dermatologists google it right in front of me).

However in the past 4 weeks i've noticed returning signs of my psoriasis starting with my fingernails.
Now i have numerous small patches which to the unaware eye seem harmless. But i (we)'ve seen this before, and we know which direction this is heading because it is slowly but surely increasing.

I take my shots at the hospital because i receive it in a "solution" not in a pen or injection. So the injection has to be made.
I had been travelling in November and took that months shot 2 weeks late. This happened again in December, 2 weeks late for my shot.
So 6 week gaps between the two. And as of last month i had closed it back to 4 weeks.

I'm regretting being so supine about it since now i am unsure if the cosentyx it self is losing its effectiveness or if it is because of my large gaps.
I'm also wondering if it is possible to do the Loading Phase again, perhaps slightly less than the first time but adding another 2 shots to my next month.

If any of you have ever "reloaded" i'd love to hear your thoughts.

[Raxyl]

I had a longer gap between Cosentyx doses a couple of months ago because my derm forgot to apply for my new script.  it stretched out to 6 weeks and by that time I was noticing the beginnings of a flare-up. So it is possible it is the same for you.

[Fred]

A few things come to my mind. First I think you are the only member not using it in a prefilled form so I'm not sure how successful it is, but I would imagine if the dose is right then it should be the same.

But a few other things are:

#1 You need to take it regular and keep taking it. I doubt a small gap would cause any problems, but it is best to stick to the recommended regime.

#2 As far as I know you can just start again, and the recommendation is:

Quote:

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If you forget to use Cosentyx If you have forgotten to inject a dose of Cosentyx, inject the next dose as soon as you remember. Then talk to your doctor to discuss when you should inject the next dose.

#3 As for doing the loading dose again. I don't think that would help unless you had been off it for a few months.

But these are just my own thoughts and I would recommend contacting your supplier or better still "Novartis" the maker of Cosentyx. *If you put "novartis contact" in a search engine you should find some contact info.

Maybe another member will have more information, but do report back.

[FRP88]

@Fred,

I had severe plaque psoriasis. Within 2 months literally everything had cleared up.
It worked better than all expectations. 100% clear. This stayed like this for 10 months until i started seeing small symptoms again in January. 
Prefilled or not, doesnt matter.

I was late in November and December. Since it's monthly its going to take atleast 3-4 of consistent use till i can say i've been consistent again.
I'm 100% committed to taking this as at exactly 30 day intervals.


I went to the dermatologist again and he suggested that "reloading" isn't necessary. Mainly getting back to the schedule and monitoring for a few months.
I was also given cortisone injections in some places where it was returning. This helps for now.

And lastly, I was also given Otezla to use supplementally to my Cosentyx.
I'm weary because of all the possible side effects. But i'm starting it on monday.
The dosing he recommended it also not as stated on the packaging, but "lighter" basically keeping it on 20mg per day for as long as possible and afterwards increasing to 30mg.


Current status, it's returned on my head, a few spots. my back, a few spots and my nails.
Compared to where i'm coming from, this is a walk in the park, and managable. But ofcourse the goal is always to try and get rid of it entirely.

Wondering is who else is using a biologic combined with another medication for plaque psoriasis and what they're experiences are.

[Fred]

@Fred,


Wondering is who else is using a biologic combined with another medication for plaque psoriasis and what they're experiences are.

Could be worth starting a new thread in Prescribed Treatments For Psoriasis

[KatT]

Hi FRP88,

I am on Cosentyx and azathioprine.  I don't really have any side effects since the azathioprine dose was cut by half (50mg instead of 100mg).

No more plaques.....PSA is another story 

[FRP88]

@KatT,

Appreciate your feedback
Still somany questions, 

How long have you been on cosentyx?
How has it worked for you?
Why and when did you start azathioprone?
How long have you been on azathioprone?
Has your dermatologist mentioned how long you should stay on it? (Mine said that the Otezla wasn't going to be a fixed thing, atleast for now, hence the question)

[KatT]

Hi FRP88

1.  I've been on Cosentyx for a year and three months approximately however my rheumatologist prescribed the wrong dosage to begin with (150 mg instead of 300 mg).  I 'very been on 300 mg for 7 months now

2. I don't have any psoriasis plaques but that being said, all treatments I've tried worked well for the psoriasis.  I have yet to find something that works for the arthritis 

3. My rheumatologist put me on azathioprine in August 2018 as he said I had also lupus after landing in the ER.....see my journal for more details on that episode....However, I don't think I have lupus

4. 100 mg af azathioprine per  day from August 2018 to November 2018.  Then he okayed for me to go on Cosentyx and reduced the azathioprine to 50 mg per day

5. No he did not....I don't think he plans on stopping the azathioprine.  

I had a bad cold when loading up un Cosentyx in 2018, another one shortly after the dose was increased.  I was losing more hair than usual on 100 mg azathioprine but that stopped when the dose was reduced.  

Hope this helps a bit