Enbrel vs. Cosentyx: Differences, similarities & side effects

In this article:

• Enbrel vs. Cosentyx: Key differences
• Enbrel vs. Cosentyx: Conditions treated
• Is Cosentyx better than Enbrel?
• Enbrel vs. Cosentyx: Insurance coverage and cost comparison
• Enbrel vs. Cosentyx side effects
• Enbrel and Cosentyx drug interactions
• Enbrel and Cosentyx drug warnings
• Can you take Enbrel and Cosentyx together?

In this article

• Enbrel vs. Cosentyx: Key differences
• Enbrel vs. Cosentyx: Conditions treated
• Is Cosentyx better than Enbrel?
• Enbrel vs. Cosentyx: Insurance coverage and cost comparison
• Enbrel vs. Cosentyx side effects
• Enbrel and Cosentyx drug interactions
• Enbrel and Cosentyx drug warnings
• Can you take Enbrel and Cosentyx together?

Enbrel (etanercept) and Cosentyx (secukinumab) are two common medications for managing certain inflammatory conditions, such as psoriatic arthritis and plaque psoriasis. Both are brand-name drugs approved by the Food and Drug Administration (FDA) and are given as subcutaneous injections.

Although they’re used for similar purposes and in similar dosage forms, they work in different ways. They may also differ in costs, side effects, and potential drug interactions. A healthcare provider can help determine the most appropriate treatment option for you.

Enbrel vs. Cosentyx: Key differences

Enbrel and Cosentyx are prescription drugs that contain different active ingredients. Enbrel contains etanercept, which blocks a specific protein called tumor necrosis factor (TNF) involved with inflammation. On the other hand, Cosentyx contains secukinumab, which targets interleukin-17A (IL-17A). Like TNF, IL-17A is also involved with inflammatory processes in the immune system.

RELATED: Enbrel generic availability, cost, and coverage

Enbrel, manufactured by Amgen, is typically given once or twice weekly as a subcutaneous injection. It is available in several forms: a single-dose prefilled syringe, a SureClick autoinjector, a single-dose vial, a multi-dose vial, and a prefilled cartridge for use with the AutoTouch reusable autoinjector.

Cosentyx, manufactured by Novartis, is often administered monthly through subcutaneous injection or intravenous infusion. It may be given with or without a loading dose, which is typically five weekly doses at the beginning of the treatment. After completing the loading dose, Cosentyx is taken once per month. It is available as a subcutaneous injection in a single-dose pen or prefilled syringe and an intravenous infusion in a single-dose vial.

Enbrel vs. Cosentyx: Conditions treated

Enbrel and Cosentyx both treat different types of arthritis and skin conditions, but they work in slightly different ways. They also have different FDA approvals for some conditions.

Enbrel is FDA approved for adults with rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and plaque psoriasis. For children, Enbrel can be used to treat polyarticular juvenile idiopathic arthritis and juvenile psoriatic arthritis in kids 2 years and older, as well as plaque psoriasis in kids 4 years and older.

Cosentyx is FDA approved to treat moderate to severe plaque psoriasis in adults and children 6 years and older who are candidates for systemic therapy or phototherapy. Cosentyx treats active psoriatic arthritis in adults and children 2 years and older, active ankylosing spondylitis in adults, and non-radiographic axial spondyloarthritis (nr-axSpA) with signs of inflammation in adults. 

In addition, Cosentyx is used to treat active enthesitis-related arthritis in children 4 years and older and moderate to severe hidradenitis suppurativa in adults. Enthesitis-related arthritis is a type of arthritis that causes pain and swelling where tendons and ligaments attach to bones. Hidradenitis suppurativa is a chronic skin condition that causes small, painful lumps to form under the skin.

Is Cosentyx better than Enbrel?

Enbrel and Cosentyx are both approved medications that have been found to be more effective than placebo in different clinical studies. 

One study compared secukinumab (the active ingredient in Cosentyx) and etanercept (the active ingredient in Enbrel) for treating moderate-to-severe plaque psoriasis. After 12 weeks, 77.1% of patients using secukinumab saw a 75% improvement in their symptoms, while only 44% of patients using etanercept saw the same results. However, both drugs had similar rates of infections as side effects, which means secukinumab may be more effective but comes with a similar safety profile as etanercept.

Another study compared secukinumab and etanercept for treating patients with psoriatic arthritis who had never used biologic treatments before. By 24 weeks, secukinumab showed better improvement of symptoms than etanercept did. However, at 12 weeks, there was no clear difference between the two drugs. Both drugs had similar side effects, but secukinumab seemed to work better in the long run.

Always consult a healthcare provider for medical advice to determine the better treatment option for your condition. Other prescription drugs may be considered, such as Humira (adalimumab) or Stelara (ustekinumab). A healthcare provider can evaluate your medical history and other medications you take before prescribing a treatment option.

RELATED: Enbrel alternatives  

Enbrel vs. Cosentyx: Insurance coverage and cost comparison

Coverage for Enbrel and Cosentyx can vary depending on your insurance plan. Some Medicare and commercial insurance plans may cover these drugs, but others may not. It’s important to check with your insurance provider or pharmacist to find out if your plan covers these medications and what your out-of-pocket costs will be. 

The average retail price of Enbrel is $8,658 for 4, 1 mL syringes, which is a one-month supply. The average retail price of Cosentyx is $7,784 for 1, 0.5 mL syringe, which is also a one-month supply. If you don’t have insurance or if your insurance doesn’t cover the full cost, you might be able to use a discount card like one from SingleCare to save. Always make sure to explore all your options to find the best way to afford your medication.

RELATED: Enbrel patient assistance program

*Cost varies by pharmacy. This is the cost at the time of publication.

Enbrel vs. Cosentyx side effects

The most common side effects of Enbrel include upper respiratory tract respiratory infections and reactions at the injection site, such as pain, itching, and swelling in the area of injection. It may also cause diarrhea and itching. 

Cosentyx is also known to cause upper respiratory tract infections, which are a common side effect. Other common side effects include diarrhea, itching, and cold sores caused by the herpes simplex virus.

Both drugs may cause serious side effects, including serious infections and allergic reactions. Seek immediate medical attention if you experience side effects that persist or worsen. 

Frequency is not based on data from a head-to-head trial. This may not be a complete list of adverse effects that can occur. Please refer to your healthcare provider to learn more.

Source: DailyMed (Enbrel), DailyMed (Cosentyx)

Enbrel and Cosentyx drug interactions

Enbrel and Cosentyx have different and overlapping drug interactions. Knowing about these interactions is important to ensure safe and effective use of these medications.

People taking Enbrel can usually get vaccinations, but they should avoid live vaccines. Some studies suggest that Enbrel might slightly lower the body’s response to certain vaccines, like the pneumococcal vaccine. Similarly, live vaccines should also be avoided with Cosentyx due to similar safety concerns.

When Enbrel is used together with other biologic drugs, such as Kineret (anakinra) or Orencia (abatacept), it raises the risk of serious infections and side effects without providing extra benefits. Research has shown that using Enbrel alongside anakinra results in more serious infections than using Enbrel by itself.

When Enbrel is taken with Azulfidine (sulfasalazine), another type of medication used for joint diseases, there might be a mild decrease in certain white blood cells. The importance of this finding is still unclear.

For Cosentyx, it’s important to be careful when using it with certain other medications broken down in the body by specific enzymes. Changes in the body caused by Cosentyx can affect how these enzymes work, which may change how well other medications work or increase their side effects. Medications affected by this enzyme process include certain benzodiazepines, statins, and immunosuppressants.

Consult a healthcare professional for other possible drug interactions.

Enbrel and Cosentyx drug warnings

Enbrel and Cosentyx both carry warnings related to serious infections and allergic reactions. Closing monitoring is recommended for signs of infection, and either drug should be discontinued if a serious infection or allergic reaction develops.

Enbrel also has the following warnings: 

• Lymphoma and other cancers, some fatal, have been reported in children and teenagers treated with TNF-blockers, including Enbrel.
• Worsening or new-onset demyelinating disease may occur. Monitoring through regular MRI scans and tracking symptoms like vision changes, muscle weakness, or coordination problems may help in early detection.
• Worsening or new onset of congestive heart failure may occur.
• Seek immediate medical attention if you experience symptoms such as unusual bruising or bleeding, persistent fatigue, frequent infections, or shortness of breath, and consider discontinuing Enbrel.
• People previously infected with the hepatitis B virus may need to be monitored for reactivation during and several months after therapy. If reactivation occurs, consider discontinuing Enbrel and beginning antiviral therapy.
• Enbrel may increase the risk of certain autoimmune conditions like lupus-like syndrome and autoimmune hepatitis.

Cosentyx also has the following warnings: 

• Cases of inflammatory bowel disease (IBD) were observed in clinical trials. Cosentyx should be used with caution in those with IBD.
• Severe skin rashes resembling eczema have been reported in some people taking Cosentyx.

Always consult with a healthcare provider to determine the best course of action if any adverse effects occur.

Can you take Enbrel and Cosentyx together?

Taking Enbrel and Cosentyx together is generally not recommended. Both medications are biologics used to treat autoimmune conditions, but they work in different ways, and combining them can increase the risk of infections and other side effects.