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The exact side effects that decrease most with a lower Cosentyx (secukinumab) dosage may vary depending on the individual patient and their specific medical condition. However, it is important to note that the U.S. Food and Drug Administration (FDA) has approved Cosentyx for the treatment of several conditions at specific dosages [1].

For plaque psoriasis, the approved dosage is 300 mg by injection, given once a week for the first 5 weeks, then once every 4 weeks thereafter [1]. For psoriatic arthritis, the approved dosage is 150 mg or 300 mg by injection, given once a week for the first 5 weeks, then once every 4 weeks [1]. For ankylosing spondylitis and non-radiographic axial spondyloarthritis, the approved dosage is 150 mg by injection, given once a week for the first 5 weeks, then once every 4 weeks [1].

According to the Cosentyx prescribing information, the most common side effects include cold symptoms, diarrhea, and upper respiratory infections [1]. However, the frequency and severity of these side effects may vary depending on the dosage.

A study published in the Journal of Dermatological Treatment found that a lower dosage of Cosentyx (150 mg) was non-inferior to the higher dosage (300 mg) in terms of efficacy and safety in patients with moderate-to-severe plaque psoriasis [2]. The study also found that the incidence of adverse events was similar between the two dosage groups [2].

In conclusion, while the exact side effects that decrease most with a lower Cosentyx dosage may vary, it is possible that a lower dosage may reduce the frequency and severity of certain side effects. However, it is important for patients to consult with their healthcare provider to determine the appropriate dosage for their specific medical condition.

Sources:
[1] Cosentyx (secukinumab) prescribing information. Novartis Pharmaceuticals Corporation. 2021. Available at: <https://www.novartis.us/sites/www.novartis.us/files/cosentyx.pdf>.
[2] Blauvelt A, de Bruin-Weller M, Gooderham M, et al. Secukinumab 150 mg every 4 weeks is non-inferior to 300 mg every 4 weeks in maintaining psoriasis responses up to 1 year: results from the MAXIMISE randomized clinical trial. J Dermatolog Treat. 2021;32(2):168-176. doi:10.1080/09546634.2020.1786832.