Occurrence of Henoch–Schönlein purpura in a patient treated with secukinumab

Reverte, M.; Etienne, Maxime; Fouchard, Maxime; Doucet, Laurent; Brenaut, E.; Miséry, Laurent

doi:10.1111/jdv.15776

Cited by 10 publications

(26 citation statements)

References 6 publications

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“…Although their numbers were lower than that observed in BS (16.0%) and FMF (17.4%), some exacerbations such as ischemic cardiovascular events in patients with large vessel vasculitis and a new onset IgA vasculitis in a patient with AS who was treated with secukinumab were considerably significant. While the latter phenomenon could be also associated with recently started secukinumab use as previously reported [ 45 ], the role of the vaccine in exacerbating inflammation could not be ignored. The low rate of disease flares in RD was consistent with other publications [ 17 – 25 ].…”

Section: Discussionmentioning

confidence: 83%

Safety of SARS-CoV-2 vaccination in patients with Behcet’s syndrome and familial Mediterranean fever: a cross-sectional comparative study on the effects of M-RNA based and inactivated vaccine

et al. 2022

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Most of the published data relate to classical forms of rheumatic diseases (RD) and information on rare inflammatory disorders such as Behçet’s syndrome (BS) and familial Mediterranean fever (FMF) is limited. We studied the frequency of side effects and disease flares after COVID-19 vaccination with either Pfizer/BioNTech or Sinovac/CoronaVac in 256 patients with BS, 247 with FMF, and 601 with RD. Telephone interviews were conducted using a questionnaire survey in a cross-sectional design in patients with BS, FMF, and RD followed by a single university hospital. Study participants were vaccinated either with CoronaVac (BS:109, FMF: 90, and RD: 343,) or BioNTech (BS: 147, FMF: 157 and RD: 258). The majority have received double dose (BS: 94.9%, FMF 92.3% and RD: 86.2%). BioNTech ensured a significantly better efficacy than CoronaVac against COVID-19 in all patient groups (BS: 1.4% vs 10.1%; FMF: 3.2% vs 12.2%, RD:2.7% vs 6.4%). Those with at least one adverse event (AE) were significantly more frequent among those vaccinated with BioNTech than those with CoronaVac (BS: 86.4% vs 45%; FMF: 83.4% vs 53.3%; and RD: 83.3% vs 45.5%). The majority of AEs were mild to moderate and transient and this was true for either vaccine. There were also AEs that required medical attention in all study groups following CoronaVac (BS: 5.5%, FMF: 3.3%, and RD:2.9%) or BioNTech (BS: 5.4%, FMF: 1.9%, and RD: 4.7%). The main causes for medical assistance were disease flare and cardiovascular events. Patients with BS (16.0%) and FMF (17.4%) were found to flare significantly more frequently when compared to those with RD (6.0%) ( p < 0.001). This was true for either vaccine. BS patients reported mainly skin-mucosa lesions; there were however, 11 (4.3%) who developed major organ attack such as uveitis, thrombosis or stroke. Flare in FMF patients were associated mainly with acute serositis with or without fever. Arthralgia/arthritis or inflammatory back pain were observed mainly in the RD group. Our study demonstrates that BS and FMF patients vaccinated with either CoronaVac or BioNTech demonstrated similar AE profile and frequency compared to RD patients. AEs that required physician consultation or hospitalization occurred in all study groups after either CoronaVac or BioNTech. Increased frequency of flares in BS and FMF compared to that seen in RD might reflect defects in innate immunity and deserves further investigation. Caution should be required when monitoring these patients after vaccination.

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Section: Discussionmentioning

confidence: 83%

Safety of SARS-CoV-2 vaccination in patients with Behcet’s syndrome and familial Mediterranean fever: a cross-sectional comparative study on the effects of M-RNA based and inactivated vaccine

et al. 2022

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“…The searches generated 1426 potentially articles that matched our predefined search strategy, of which 55 were included in this review (Figure 1): 2 clinical studies, 11,12 2 review, 9,13 50 case reports 5,6,14–61 and 1 case series, 62 published between 2016 and 2021. More than 1077 patients (aged 18–74 years) experienced AESI after secukinumab treatment for Ps, PsA, AS, spondyloarthritis (SpA), and/or palmoplantar psoriasis (PPP).…”

Section: Resultsmentioning

confidence: 99%

“…Vasculitis comprises a very heterogeneous group of diseases characterized by blood vessel inflammation and necrosis, and has been linked to drugs, infections, malignancies or connective tissue diseases. 87 To date, there have been reported eight cases of vasculitis secondary to secukinumab (four with cutaneous vasculitis, 5,[20][21][22] one with cutaneous and digestive vasculitis, 61 and three with Behçet's disease 23,24 between these cytokines. 90,91 The pathogenesis of vasculitis induced by secukinumab is therefore thought to implicate a new imbalance of multiple regulator/effector cytokines and immunological pathways of IL-17 cells, similar to related hypothesis for anti-TNF-ɑ inhibitors that are the most common biological agents-induced vasculitis.…”

Section: Drug-associated Vasculitismentioning

confidence: 99%

Review of secukinumab‐induced adverse events of special interest and its potential pathogenesis

Liang

Zhang

et al. 2022

Dermatologic Therapy

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Although secukinumab has demonstrated high efficacy and favorable safety in moderate‐to‐severe psoriasis and psoriatic arthritis, patients developing adverse events of special interest (AESI) were reported increasingly in real‐world practice. A systematic literature search of the PubMed database was conducted to identify clinical studies or case reports on secukinumab‐induced AESI. More than 1077 patients (aged 18–74 years) from 55 studies were reported to have 24 AESI 3 days to 96 weeks after secukinumab treatment. The four most common AESI was inflammatory bowel disease (n > 1000), eczematous drug eruption (n > 30), drug‐associated vasculitis (n = 8), and drug‐induced lupus erythematosus (n = 4). Most of these AESI were only mild to moderately severe and resolved after secukinumab discontinuation without or with symptomatic treatment. Secukinumab has the potential to develop a number of AESI by probably dysregulating the different expression of polar T‐cell axes (Th1, Th2, Th17, Th22, and/or Treg) and driving various cytokines in some patients. Physicians should be aware of these AESI for timely diagnosis and proper treatment.

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“…Reverte et al described a case of Henoch-Schönlein purpura (HSP) in a patient treated with secukinumab for psoriasis, successfully replaced by etanercept without recurrence of HSP [ 58 ].…”

Section: Il-17 Inhibitorsmentioning

confidence: 99%

Hematologic side effects of biologics and kinase inhibitors used in rheumatologic diseases: a review of the current evidence

et al. 2022

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Treatment options for various rheumatologic diseases have been limited until the introduction of biologic agents and kinase inhibitor therapy in recent decades. Since their arrival, they have steadily been integrated into routine management. Given their wide use and overall successful outcomes, it becomes increasingly pertinent for clinicians to readily identify their side effects. Their effects can involve multiple organ systems, including hematologic. This review aims to identify and classify the range of hematologic effects associated with individual biologics and kinase inhibitors used for treatment of rheumatologic diseases.

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Occurrence of Henoch–Schönlein purpura in a patient treated with secukinumab

Cited by 10 publications

References 6 publications

Safety of SARS-CoV-2 vaccination in patients with Behcet’s syndrome and familial Mediterranean fever: a cross-sectional comparative study on the effects of M-RNA based and inactivated vaccine

Safety of SARS-CoV-2 vaccination in patients with Behcet’s syndrome and familial Mediterranean fever: a cross-sectional comparative study on the effects of M-RNA based and inactivated vaccine

Review of secukinumab‐induced adverse events of special interest and its potential pathogenesis

Hematologic side effects of biologics and kinase inhibitors used in rheumatologic diseases: a review of the current evidence

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