Report of two cases of Behçet's disease developed during treatment with secukinumab

Barrado-Solís, Nerea; Rodrigo-Nicolás, Beatriz; Morena-Barrio, I. de la; Pérez‐Pastor, Gemma; Sanchis-Sánchez, Celia; Tomás-Cabedo, G; Valcuende‐Cavero, Francisca

doi:10.1111/jdv.16454

Cited by 14 publications

(12 citation statements)

References 8 publications

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“…6,8,9,12 The authors attributed SEC-related Behçet syndrome to the alterations in cytokine pathways, pointing to the paradoxical reaction. 7,27,28 In addition, inhibition of IL-17 may increase lymphocyte migration to tissue by promoting interferon α production, thereby triggering paradoxical psoriasis. Hence, except for IBD, SEC-related inflammatory adverse events appear to be a paradoxical reaction.…”

Section: Discussionmentioning

confidence: 99%

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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: Discussionmentioning

confidence: 99%

“…3 Besides these adverse effects, inflammatory conditions or vasculitis induced by these agents have also been reported. [4][5][6][7][8][9][10] We herein describe a patient with refractory psoriasis in which clinical features of IgA vasculitis were observed after SEC treatment with a literature review.…”

mentioning

confidence: 99%

Secukinumab‐induced IgA vasculitis in a patient with psoriatic arthritis

Ozince

Erzın

et al. 2023

Int J of Rheum Dis

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“…It has recently received Food and Drug Administration and European Medicines Agency approval for the treatment of pediatric patients with enthesitis-related arthritis, psoriatic arthritis, and psoriasis. Some isolated reports, however, have highlighted de novo BD or BD exacerbation after starting secukinumab therapy [ 133 , 134 ].…”

Section: Treatmentmentioning

confidence: 99%

Treatment Options in Pediatric Behçet’s Disease

2023

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Behçet’s disease is a rare and poorly understood vasculitis affecting blood vessels of all types and sizes. Uveitis and oral and genital ulcers represent the typical clinical triad. Populations along the ancient trading route connecting the Mediterranean basin with the Middle and Far East are most affected. Up to a quarter of the cases has a pediatric onset, typically around puberty. The aim of the treatment is early intervention to control inflammation, with symptom relief and prevention of relapses, damage, and complications. The heterogeneous clinical presentation often requires a multidisciplinary and tailored approach. Ocular, neurological, gastrointestinal, and vascular involvement is associated with a worse prognosis and needs more aggressive treatments. In young patients with expected prolonged disease, treatment should also focus on preventive measures and lifestyle advice. In recent years, the pharmacological armamentarium has grown progressively, although only a limited number of drugs are currently authorized for pediatric use. Most evidence for these drugs still derives from adult studies and experience; these are prescribed as off-label medications and are only available as adult formulations. Corticosteroids frequently represent the mainstay for the management of the initial acute phases, but their potential serious adverse effects limit their use to short periods. Different conventional disease-modifying anti-rheumatic drugs have long been used. Many other biologic drugs targeting different cytokines such as interleukin-1, interleukin-6, and interleukin-17 and treatments with small molecules including the phosphodiesterase 4 and Janus kinase inhibitors are emerging as novel promising therapeutic agents. In recent years, a growing interest has developed around anti-tumor necrosis factor agents that have often proven to be effective in severe cases, especially in those with a gastrointestinal and ocular involvement.

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“…In two patients, another biological agent was introduced without recurrence (etanercept and infliximab). [73][74][75][76][77][78]…”

Section: Secukinumabmentioning

confidence: 99%

Vasculitis induced by biological agents used in rheumatology practice: A systematic review

Duran¹,

Paz²,

Santiago³

2021

Arch Rheumatol

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Objectives: Biological medications have been used with an increasing frequency to treat rheumatological diseases. Autoimmune events can be induced by these drugs, such as psoriasiform lesions, alopecia, lupus and, vasculitis, which more often affects the skin (small-sized vessels) and eventually other organs. In this review, we describe the clinical profile of patients with vasculitis induced by the main biological agents used in rheumatology. Patients and methods: We performed a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. The PubMed database was used for searching eligible articles. We included case reports, case series, and letter to the editor of patients on anti-tumor necrosis factor-alpha (anti-TNF-a) molecules, as well as tocilizumab, ustekinumab, secukinumab, rituximab, and abatacept, who had vasculitis induced by these agents. Results: Eighty-one articles were included for final analysis (n=89). Twenty-seven patients were using infliximab, 20 adalimumab, 18 etanercept, seven secukinumab, four certolizumab, four rituximab, three golimumab, three ustekinumab, two abatacept, and one tocilizumab. Unspecific leukocytoclastic vasculitis (LCV) was the most common type of vasculitis (n=37), followed by anti-neutrophil cytoplasmic antibody (ANCA)- associated vasculitis (n=16). The medication was replaced with another biological molecule in 23 cases, with only four relapses. In six cases, the biological was maintained, but vasculitis worsened/persisted in one case, being necessary drug removal. Conclusion: Infections, infusion reaction, cancer, and autoimmune events are well-known side effects of biological therapy. This review demonstrates that vasculitis is another adverse effect of this type of therapy, particularly the anti-TNF-a molecules, and LCV the most reported type of vasculitis.

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Report of two cases of Behçet's disease developed during treatment with secukinumab

Abstract: mian A. Associations between site of skin lesions and depression, social anxiety, body-related emotions and feelings of stigmatization in psoriasis patients.

Cited by 14 publications

References 8 publications

Secukinumab‐induced IgA vasculitis in a patient with psoriatic arthritis

Secukinumab‐induced IgA vasculitis in a patient with psoriatic arthritis

Treatment Options in Pediatric Behçet’s Disease

Vasculitis induced by biological agents used in rheumatology practice: A systematic review

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