Physicians now have the option of a new treatment for arthritis in children. Secukinumab has received US FDA approval as a treatment option for active enthesitis-related arthritis (ERA) in children and adolescents aged 4 years and older and psoriatic arthritis (PsA) in children and adolescents aged 2 years and older.

Secukinumab is a human interleukin (IL)-17A antagonist and is the first and only human biologic approved for use in both enthesitis-related arthritis and juvenile PsA.

Dose and administration: It is available in doses of 75 mg in children weighing 15 kg to < 50 kg or 150 mg in children with body weight ≥50 kg and is administered as a subcutaneous injection by a pre-filled syringe or pen every 4 weeks after the initial loading doses

Contraindications: Known hypersensitivity to secukinumab or to any of the excipients

Adverse effects: Nasopharyngitis, diarrhea, upper respiratory infections

Warning and precautions

• Increased risk of serious infections; hence to be used cautiously in patients with chronic/recurrent infections
• Test for TB before initiating treatment
• Avoid use of live vaccines in patients receiving secukinumab
• New onset of inflammatory bowel disease or flare‐ups of pre-existing IBD may occur.

The approval was based on results of the phase III JUNIPERA trial (NCT03031782), which demonstrated that children and adolescents aged 2-17 years with active ERA or JPsA treated with secukinumab showed longer time to disease flare showing a 53% reduction in the risk of flare for ERA and 85% reduction in the risk of flare for JPsA compared to placebo.

Source: FDA approves Secukinumab (Cosentyx) for pediatric arthritis - Medscape - Dec 23, 2021.