Abatacept and Secukinumab: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 16, 2026 · Source data updated Jul 16, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Abatacept
Secukinumab
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Both of these medicines calm down your immune system. Abatacept (Orencia) and secukinumab each work on different parts of your body's defenses to ease inflammation from conditions like arthritis or psoriasis. The concern is that taking them together may lower your defenses too much at the same time, which can raise your risk of getting a serious infection without giving you any extra benefit.
This is based more on how these drugs work and on studies of similar combinations than on direct proof, but the caution is real. Because of that, this pairing is generally not recommended. Please talk with your doctor or pharmacist before using both, and let them know right away if you get a fever, chills, or signs of infection.
Effect: Additive immunosuppression, raising the risk of serious infection with no added therapeutic benefit.
- Direction/mechanism: Both are biologics acting on the immune system (abatacept modulates T-cell costimulation; secukinumab is an anti-IL-17A antibody). Neither is a prodrug. The concern is pharmacodynamic (additive immune suppression), not a metabolic PK interaction. Precise mechanism unknown.
- Evidence: Theoretical, extrapolated from controlled trials of abatacept plus TNF antagonists showing increased serious infections. Data with other RA/PsA biologics are insufficient.
- Onset: Unspecified.
- Management: Concurrent use is not recommended. If transitioning between agents, monitor for signs of infection.
What happens
An increased risk of infection
Interaction Deep Dive
In controlled clinical trials, combining abatacept with tumor necrosis factor (TNF) antagonists was shown to raise the likelihood of serious infection while offering no extra therapeutic benefit. Data are inadequate to judge the safety and efficacy of using abatacept together with anakinra or with biologics indicated for rheumatoid arthritis or psoriatic arthritis, so combining abatacept with these agents is not advised. Patients being switched from TNF antagonist therapy to abatacept should be watched for signs of infection1.
Why it happens (mechanism)
Unknown
How to manage this interaction
The main point: combining abatacept with secukinumab is generally not recommended because the extra immune suppression can raise your infection risk without added benefit.
- Do not start, stop, or change either drug on your own. Talk with your prescriber or pharmacist about whether you should be on both.
- Your care team will usually choose one biologic rather than using them together.
- If you are switching from one of these to the other, your team may watch you more closely for signs of infection.
- Report fever, chills, cough, sore throat, or wounds that won't heal right away.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
2 reports — tap to read
a) Taking abatacept together with etanercept did not provide any extra efficacy but did raise the risk of serious infection when compared with etanercept used by itself. In a 1-year randomized study (N=121) that was followed by an open-label long-term extension (LTE; n=80), rheumatoid arthritis patients who were already receiving etanercept 25 mg twice/week continued that etanercept and were randomized to receive either abatacept 2 mg/kg IV on days 1, 15, and 30, and thereafter every 4 weeks (n=85) or placebo (n=36). After finishing the double-blind portion, patients qualified for the LTE phase, during which the abatacept dose was raised to roughly 10 mg/kg. At 6 months, the 2 mg/kg abatacept group demonstrated no significant improvement relative to the placebo group in modified American College of Rheumatology 20% (ACR20; 48.2% vs 30.6%) or ACR50 (25.9% vs 19.4%) response rates, though there was a significant difference in modified ACR70 rates (10.6% vs 0%). At 1 year, no significant differences in ACR20, 50, or 70 response rates were seen between the two groups. Serious adverse events occurred more often in the 2 mg/kg abatacept group (16.5%) at one year and in the 10 mg/kg abatacept group after 2 years of LTE (32.5%) than in the placebo group (2.8%). Serious infections at 1 year were noted in 3.5% of the 2 mg/kg abatacept group and 0% of the placebo group 2.
b) In controlled clinical trials involving adults with active rheumatoid arthritis who received abatacept together with a tumor necrosis factor (TNF) antagonist (n=204), compared with those on TNF antagonist therapy alone (n=134), the rate of infection (63% vs 43%, respectively) and of serious infection (4.4% vs 0.8%, respectively) was higher with the combined therapy; furthermore, the combined therapy offered no additional benefit 1.
Common questions
Can I take Abatacept and Secukinumab together?
Using abatacept and secukinumab together is generally not recommended because it can increase your risk of serious infection; ask your doctor or pharmacist which single medicine is right for you. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Abatacept and Secukinumab interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Abatacept and Secukinumab interaction managed?
The main point: combining abatacept with secukinumab is generally not recommended because the extra immune suppression can raise your infection risk without added benefit. Do not start, stop, or change either drug on your own. Talk with your prescriber or pharmacist about whether you should be on both. Your care team will usually choose one biologic rather than using them together. If you are swit… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Abatacept or Secukinumab need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (2)
- Product Information: ORENCIA(R) intravenous, subcutaneous injection, abatacept intravenous, subcutaneous injection. Bristol-Myers Squibb Company (per FDA), Princeton, NJ, 2020. DailyMed
- Weinblatt M, Schiff M, Goldman A, et al: Selective costimulation modulation using abatacept in patients with active rheumatoid arthritis while receiving etanercept: a randomised clinical trial. Ann Rheum Dis 2007; 66(2):228-234. PubMed
Keep reading about Abatacept
Keep reading about Secukinumab
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
Check another combination
Our instant two-drug interaction checker is almost here.
Still have questions about this combination?
Every question gets a real answer from a licensed pharmacist — free, and usually within a day.
Ask the pharmacist