Behçet’s‐like disease during secukinumab treatment: new paradoxical reaction?

Calleja‐Algarra, Alba; Miguel, Raquel Aragón; Lencina, Juan José Andrés; Martín, B. Pinilla; Alonso, Carolina Mancho; Peralto, J.L. Rodríguez; Romero, Pablo Luis Ortiz; Díaz, Raquel Rivera

doi:10.1111/ddg.14196

Cited by 9 publications

(7 citation statements)

References 11 publications

(11 reference statements)

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“…In addition, the fact that our patient has many features in common with other cases in the literature supports the diagnosis. 6,12,[15][16][17][18][19][20] Similar to our case, it has been reported that SEC led to the worsening of LCV in one patient with reactive arthritis treated primarily with infliximab. 17 Also, most of the reported cases of SEC-related vasculitis had clinical and/ or histopathological features of IgA vasculitis.…”

Section: Discussionsupporting

confidence: 88%

“…[12][13][14] Similar to SEC-related vasculitis cases (presented in Table 1), these cases range from vasculitis confined to the skin to severe systemic vasculitis requiring high-dose immunosuppressive therapy. 6,[15][16][17][18][19][20] Our patient, however, was unique in terms of intestinal involvement and IgA nephropathy in addition to LCV. On the other hand, it is also possible that adalimumab, which was used before SEC, might have also contributed to the clinical picture of our patient because anti-TNF agents can cause both IgA nephropathy and LCV.…”

Section: Discussionmentioning

confidence: 75%

“…Several medications (eg nonsteroidal anti‐inflammatory drugs, antibiotics, statins) and monoclonal antibodies (eg TNF inhibitors, tocilizumab, and rituximab) have been related to vasculitis 12–14 . Similar to SEC‐related vasculitis cases (presented in Table 1), these cases range from vasculitis confined to the skin to severe systemic vasculitis requiring high‐dose immunosuppressive therapy 6,15–20 . Our patient, however, was unique in terms of intestinal involvement and IgA nephropathy in addition to LCV.…”

Section: Discussionmentioning

confidence: 80%

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Secukinumab‐induced IgA vasculitis in a patient with psoriatic arthritis

Ozince

Erzın

et al. 2023

Int J of Rheum Dis

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ObjectivesSecukinumab (SEC) is an effective and widely used drug in psoriatic disease and axial spondyloarthritis. However, SEC has been found to be associated with inflammatory conditions and vasculitis. These inflammatory adverse effects may complicate the treatment of underlying disease, and clinicians may experience difficulties in recognizing and managing this unusual condition.Case ReportA man aged 56 years with psoriatic disease refractory to conventional disease‐modifying antirheumatic drugs was given adalimumab for 6 weeks, then switched to SEC when his psoriatic lesions were exacerbated. After 3 weeks of SEC treatment, he developed systemic features of IgA vasculitis while his skin lesions and arthritis persisted.ConclusionsAlthough SEC‐related inflammatory adverse events, including vasculitis, are rarely encountered in clinical practice, it is essential to recognize them because they can be mistaken as a component of the underlying inflammatory disease. In addition, the dramatic improvement in many cases after the cessation of SEC underlines the importance of making an accurate diagnosis. Pathogenetically, these adverse events are likely to be paradoxical reactions, except for SEC‐induced inflammatory bowel diseases. However, in many aspects, their pathogenesis is controversial and needs clarification.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 80%

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Secukinumab‐induced IgA vasculitis in a patient with psoriatic arthritis

Ozince

Erzın

et al. 2023

Int J of Rheum Dis

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“…Four cases of generalized pustular psoriasis and four cases of localized PPP have been published but, unlike our two cases, these had a previous history of psoriasis. As with other paradoxical reactions, they presented good control after discontinuation of the drug or change to another biologic with a different mechanism of action [11,12]. The exact mechanism of cytokine dysregulation leading to the appearance of these lesions, as well as possible risk factors, are currently unknown [13].…”

Section: Palmoplantar Pustulosis Under Secukinumab In Two Patients Wi...mentioning

confidence: 96%

Palmoplantar pustulosis under secukinumab in two patients without psoriasis

Penalba-Torres¹,

Díaz

2021

J Deutsche Derma Gesell

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“…On the other hand, there are some case reports reporting exacerbation of BS symptoms or emergence of de novo BS. [63][64][65] Three patients with PsA and one with AS developed de novo BS. All patients developed mucocutaneous symptoms.…”

Section: Tocilizumabmentioning

confidence: 99%

Recent Insights into the Management of Behçet Syndrome

Özgüler¹,

Özdede²,

Hatemi³

2021

JIR

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Behçet syndrome (BS) is a multisystem vasculitis with variable vessel involvement that shows significant heterogeneity among patients in terms of clinical manifestations and disease course. Treatment choice and response are both influenced by this heterogeneity. BS treatments' main goals are to quickly suppress inflammatory exacerbations and prevent relapses in order to protect organ functions and provide good quality of life. Besides the long-term experience with steroids and traditional immunosuppressives, biologic drugs, especially TNF inhibitors, have gained increasing importance in the treatment of BS over the years. In this review, we aimed to give an overview of the studies with conventional and biological drugs with proven efficacy in the treatment of BS, as well as promising drugs and current management strategies according to clinical phenotypes.

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Behçet’s‐like disease during secukinumab treatment: new paradoxical reaction?

Cited by 9 publications

References 11 publications

Secukinumab‐induced IgA vasculitis in a patient with psoriatic arthritis

Secukinumab‐induced IgA vasculitis in a patient with psoriatic arthritis

Palmoplantar pustulosis under secukinumab in two patients without psoriasis

Recent Insights into the Management of Behçet Syndrome

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