Sotyktu vs. Cosentyx: 6 Differences for Plaque Psoriasis - GoodRx (2024)

If you’re living with plaque psoriasis, you may have been prescribed creams or ointments to help. But if they fail, your dermatologist may consider an oral or injectable medication.

Sotyktu (deucravacitinib)and Cosentyx (secukinumab) are two newer treatment options for moderate-to-severe psoriasis. They’re both effective for improving symptoms such as redness, itching, and pain. But they differ in formulation, dosing, side effects, and more.

Below, we’ll review six differences between Sotyktu and Cosentyx.

1. Sotyktu is an oral pill, while Cosentyx is an injection

An obvious difference between Sotyktu and Cosentyx is how you take them. Sotyktu is a pill that you take by mouth, while Cosentyx is a subcutaneous (under the skin) injection. Cosentyx is also available as an infusion, but it’s only given in a medical setting for other medical conditions.

Sotyktu tablets are taken by mouth once a day, with or without food. The tablets should be swallowed whole — do not cut, crush, or chew them.

Cosentyx comes in a prefilled syringe and injection pen (UnoReady and Sensoready Pens). For children and adults, it’s injected once a week for the first 5 doses, then every 4 weeks after that. The dosage for children is based on their body weight.

If you don’t like injections, an oral medication like Sotyktu may be an option. Or you may prefer the convenience of Cosentyx injections if you have trouble swallowing tablets or remembering to take a daily pill.

2. Sotyktu and Cosentyx work differently for plaque psoriasis

Many psoriasis treatments target the immune system — including Sotyktu and Cosentyx. This is because psoriasis is thought to be caused by an overactive immune system. Both medications help lower inflammation and improve symptoms of plaque psoriasis. But they have this effect in different ways.

Sotyktu is a tyrosine kinase 2 (TYK2) inhibitor. It’s not fully clear how it works to treat plaque psoriasis. Experts believe it might be due to the way it blocks activation of a protein called TYK2. This helps prevent the release of chemicals that cause inflammation in the body. Sotyktu is the first and only medication of its kind approved for psoriasis.

Cosentyx is a biologic — a medication made from living sources. It’s a lab-made antibody that attaches to a chemical called interleukin-17A (IL-17A). Normally, IL-17A works to promote inflammation. Cosentyx prevents it from working, thus lowering inflammation.

3. Cosentyx is approved for use in children, while Sotyktu is only approved for adults

Sotyktu and Cosentyx are both approved to treat moderate-to-severe plaque psoriasis in adults. But Cosentyx is also approved for children ages 6 and older. Along with Enbrel (etanercept), Taltz (ixekizumab), and Stelara (ustekinumab), Cosentyx is one of four biologics approved for psoriasis in children.

Sotyktu is currently being studied for moderate-to-severe plaque psoriasis in children as young as 6 years old. So, it could be approved for younger age groups in the future.

4. Sotyktu and Cosentyx can cause different side effects

Sotyktu and Cosentyx share some similar side effects. But they have a few different ones, too. For example, diarrhea was one of the most commonly reported side effects during initial Cosentyx trials. Diarrhea was also reported with Sotyktu, but people who didn’t receive Sotyktu reported diarrhea at a similar or higher rate.

Some people notice eczema-like skin reactions, such as red, itchy bumps, days to months after starting Cosentyx. If this happens, you may be told to stop Cosentyx until the reaction resolves. This type of reaction hasn’t been reported with Sotyktu. But you may notice skin-related side effects such as inflamed hair pores and acne.

Both Sotyktu and Cosentyx weaken the immune system. This means they can put you at a higher risk for getting an infection — ranging from the common cold to more serious infections. Serious infections reported with Sotyktu include pneumonia and COVID-19. Yeast infections, herpes, and certain types of skin infections have been reported with Cosentyx.

5. Sotyktu and Cosentyx may be covered differently by your insurance plan

Insurance coverage of Sotyktu and Cosentyx depends on your specific plan. Insurance plans usually have a formulary, which is a list of medications that cover at a preferred rate.

For both medications, some insurance plans may require step therapy. This means you’ll have to try alternative treatments first. After that, they may cover Sotyktu or Cosentyx. Some plans require you to try more options before they’ll cover Sotyktu compared with Cosentyx. And in some cases, you may need to try Cosentyx first before Sotyktu is covered.

Contact your insurance company for more details on coverage of these medications. If these medications aren’t covered, your prescriber may submit a prior authorization. And if they’re still not covered, the manufacturer may offer financial help. Ways you can save on your prescription include copay savings cards and patient assistance programs.

6. Cosentyx has approved uses beyond plaque psoriasis

Sotyku is only approved to treat plaque psoriasis. But Cosentyx also treats other inflammatory health conditions. In addition to plaque psoriasis, these include:

• Psoriatic arthritis

• Ankylosing spondylitis

• Non-radiographic axial spondyloarthritis

• Enthesitis-related arthritis

• Hidradenitis suppurativa

Be sure to discuss your full medical history with your dermatologist. They may consider other health conditions you have when choosing medications for your psoriasis. For example, up to 30% of people with psoriasis also have psoriatic arthritis. This can make Cosentyx a better option for someone with both conditions.