Generalized pustular psoriasis associated with systemic lupus erythematosus successfully treated with secukinumab

Akaji, Kazuya; Nakagawa, Yukinobu; Kakuda, Kasumi; Takafuji, Madoka; Kiyohara, Eiji; Murase, Chiaki; Takeichi, Takuya; Akiyama, Masashi; Fujimoto, Manabu

doi:10.1111/1346-8138.15645

Cited by 6 publications

(5 citation statements)

References 4 publications

(7 reference statements)

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“…No unexpected safety signals were collected, with nasopharyngitis (6, 50.0%) as the most common AE registered. 94 Several case reports seem to confirm these results, [95][96][97][98][99][100][101][102] also during pregnancy. 103,104 Secukinumab seems to be a valuable weapon for GPP also in pediatric patients, as reported in a 48-week retrospective real-world study involving 18 pediatric patients (mean age 7.9 ± 2.3 years) receiving secukinumab 75 mg at weeks 0, 1, 2, 3, and 4 and then every 4 weeks, with the purpose of assessing the change in the Generalized Pustular Psoriasis Area and Severity Index (GPPASI) and Generalized Pustular Psoriasis Physician Global Assessment (GPPGA) scores from the baseline to weeks 2, 4, 12, 24, and 48.…”

Section: Secukinumabmentioning

confidence: 70%

Use of Biological Therapies for the Management of Pustular Psoriasis: A New Era?

Megna¹,

Camela²,

Ruggiero³

et al. 2023

CCID

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Generalized pustular psoriasis (GPP) is a severe and rare form of psoriasis, being a potentially life-threatening condition, characterized by recurring episodes or flares of widespread cutaneous erythema with macroscopic sterile pustules. An irregular innate immune response is linked to GPP, which is considered an auto-inflammatory disorder, while innate and adaptive immunopathogenic responses are involved in psoriasis pathogenesis. In consequence, different cytokine cascades have been suggested to be mainly involved in the pathogenesis of each different psoriasis form, with the interleukin (IL)23/IL17 axis implied in plaque psoriasis, and the IL36 pathway in the GPP. As regards GPP treatment, conventional systemic drugs available for plaque psoriasis are usually used as the first-line treatment option. However, contraindications and adverse events often limit the use of these therapies. In this scenario, biologic drugs may represent a promising treatment option. To date, even if 12 different biologics have been approved for plaque psoriasis, none of these is approved for GPP where they are employed off-label. Recently, spesolimab, an anti-IL36 receptor monoclonal antibody, has been recently approved for GPP. The purpose of this article is to assess the current literature about the use of biological therapies for the treatment of GPP to establish the basis for a shared GPP management algorithm.

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Section: Secukinumabmentioning

confidence: 70%

Use of Biological Therapies for the Management of Pustular Psoriasis: A New Era?

Megna¹,

Camela²,

Ruggiero³

et al. 2023

CCID

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“…Drug-related, lupus-like skin reactions were observed in patients treated with IL-17 inhibitors [54]. However, there are two case reports from Japan of a favorable SEC treatment in patients with concomitant SLE and PsO, or PsA [55,56]. Considering IL-23 inhibitors, a case report of new-onset SLE in a patient on RIS therapy was described, as well as a case report of refractory lupus erythematosus tumidus that was responsive to TIL [57,58].…”

Section: Skin Lupusmentioning

confidence: 99%

“…If not, clinicians should search for organ damage, a different diagnosis, or another therapy option. There are case reports about the successful SEC treatment of skin lupus that is accompanied with a fever, with the resolution of hypocomplementemia, and the decrease of SLE-related autoantibodies [55,82]. The relation between Th17-targeted therapies and autoantibody production has to be elucidated.…”

Section: Neuropsychiatric Hematological and Other Presentations Of Slementioning

confidence: 99%

Is Th17-Targeted Therapy Effective in Systemic Lupus Erythematosus?

Petrić

Radić

2023

CIMB

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Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a broad spectrum of clinical manifestations. The proposed pathophysiological hypotheses of SLE are numerous, involving both innate and adaptive abnormal immune responses. SLE is characterized by the overproduction of different autoantibodies that form immune complexes, which cause damage in different organs. Current therapeutic modalities are anti-inflammatory and immunosuppressive. In the last decade, we have witnessed the development of many biologicals targeting different cytokines and other molecules. One of them is interleukin-17 (IL-17), a central cytokine of a proinflammatory process that is mediated by a group of helper T cells called Th17. Direct inhibitors of IL-17 are used in psoriatic arthritis, spondyloarthritis, and other diseases. Evidence about the therapeutic potential of Th17-targeted therapies in SLE is scarce, and probably the most promising is related to lupus nephritis. As SLE is a complex heterogeneous disease with different cytokines involved in its pathogenesis, it is highly unlikely that inhibition of only one molecule, such as IL-17, will be effective in the treatment of all clinical manifestations. Future studies should identify SLE patients that are eligible for Th17-targeted therapy.

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“…3 A few case reports suggest that secukinumab is effective in controlling lupus nephritis. [4][5][6] However, accumulating reports show that secukinumab treatment could induce [7][8][9][10][11] or aggravate cutaneous lupus erythematosus (CLE). 12 Only one case about secukinumabinduced lupus nephritis has been reported.…”

Section: Introductionmentioning

confidence: 99%

Membranous lupus nephritis secondary to secukinumab therapy: A case report and literature review

Zhou,

2024

Lupus

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The interleukin (IL)-17 axis is involved in many inflammatory and autoimmune diseases. Secukinumab, an IL-17 inhibitor, has been approved for psoriasis treatment. There are accumulating cases of lupus erythematosus induced by IL-17 inhibition. Lupus nephritis after IL-17 inhibition has not been reported. We report the case of a 57-year-old man who developed membranous lupus nephritis after secukinumab treatment for psoriasis. Anti-SSA and PM-Scl antibodies were positive. dsDNA, anti-Smith, and anti-histone antibodies were negative, and serum complement was low. Secukinumab was discontinued, while tacrolimus was initiated, subsequently switched to cyclosporin, belimumab, glucocorticosteroid, and hydroxychloroquine with a good response. The relationship between lupus erythematosus and IL-17 inhibition requires further research.

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Generalized pustular psoriasis associated with systemic lupus erythematosus successfully treated with secukinumab

Cited by 6 publications

References 4 publications

Use of Biological Therapies for the Management of Pustular Psoriasis: A New Era?

Use of Biological Therapies for the Management of Pustular Psoriasis: A New Era?

Is Th17-Targeted Therapy Effective in Systemic Lupus Erythematosus?

Membranous lupus nephritis secondary to secukinumab therapy: A case report and literature review

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