Does Cosentyx (Secukinumab) Cause Weight Gain?
No, Cosentyx (secukinumab) is not associated with weight gain as a recognized adverse effect based on available clinical evidence and FDA-approved prescribing information.
Evidence from Clinical Guidelines and Drug Information
The provided evidence does not identify weight gain as a documented adverse effect of secukinumab. When reviewing the FDA-approved prescribing information and clinical guidelines for Cosentyx:
The most common adverse events associated with secukinumab include upper respiratory tract infections, oral herpes, headache, rhinorrhea, diarrhea, nausea, and fatigue—weight gain is notably absent from this list 1.
Monitoring recommendations for patients on secukinumab focus on tuberculosis screening, complete blood counts for neutropenia, inflammatory markers, and signs of infection—but do not include weight monitoring as a concern 2.
Large-scale comparative trials such as the EXCEED study (853 patients comparing secukinumab versus adalimumab over 52 weeks) did not report weight gain as a safety concern or adverse event in either treatment arm 3.
Context: Medications That Do Cause Weight Gain
To put this in perspective, comprehensive reviews of medications associated with weight gain consistently identify specific drug classes as problematic:
- Antipsychotics (particularly olanzapine, clozapine, quetiapine) 4, 5
- Glucocorticoids (oral steroids like prednisone) 4
- Certain antiepileptics (gabapentin, pregabalin, valproic acid) 4
- Some hormonal contraceptives (medroxyprogesterone acetate) 4
Secukinumab, as an IL-17A inhibitor biologic, does not appear in any systematic reviews of obesogenic medications 6, 7.
Clinical Implications
You can reassure patients that weight gain is not an expected side effect of Cosentyx therapy.
If a patient on secukinumab experiences weight gain, investigate other potential causes including concomitant medications (particularly glucocorticoids, which are sometimes used for inflammatory conditions), disease activity changes, or lifestyle factors 4.
Focus monitoring efforts on the documented risks: infections (particularly upper respiratory and candidiasis), neutropenia, and inflammatory bowel disease exacerbations 1, 2.