Sarcoidosis Developing During Secukinumab Therapy: Case Report

Nyckowski, Timothy; Ceilley, Roger I.; Wilson, Joshua

doi:10.25251/skin.1.2.7

Cited by 8 publications

(9 citation statements)

References 8 publications

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“…Previous reports suggest a favorable effect of secukinumab in two cases of sarcoidosis associated with TNF antagonists (55,56). Conversely, our review of the literature identified two cases of sarcoidosis that either developed or worsened in patients taking secukinumab and ixekizumab (57,58). However, a previous multicentre, randomized, double blind, phase II trial, assessing the efficacy and safety of secukinumab in non-infectious uveitis did not identify any safety concerns in the included patients with sarcoidosis (n = 4) (59).…”

Section: Interleukin-17 Blockingmentioning

confidence: 64%

Emerging Molecular Targets for the Treatment of Refractory Sarcoidosis

et al. 2020

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Sarcoidosis is a multisystem granulomatous disease of unknown origin that has variable clinical course and can affect nearly any organ. It has a chronic course in about 25% of patients. Corticosteroids (CS) are the cornerstone of therapy but their long-term use is associated with cumulative toxicity. Commonly used CS-sparing agents include methotrexate, cyclophosphamide, azathioprine, and mycophenolate mofetil. Twenty to forty percentage of sarcoidosis patients are refractory to these therapies or develop severe adverse events. Therefore, additional and targeted CS-sparing agents are needed for chronic sarcoidosis. Macrophage activation, interferon response, and formation of the granuloma are mainly mediated by T helper-1 responses. Different pro-inflammatory cytokines such as interleukin (IL)-8, IL-12, IL-6, and tumor necrosis factor-alpha (TNF-α) have been shown to be highly expressed in sarcoidosis-affected tissues. As a result of increased production of these cytokines, Janus kinase-signal transducer and activator of transcription (JAK-STAT) signaling is constitutively active in sarcoidosis. Several studies of biological agents that target TNF-α have reported their efficacy and appear today as a second line option in refractory sarcoidosis. Some case series report a positive effect of tocilizumab an anti-IL-6 monoclonal antibody in this setting. More recently, JAK inhibition appears as a new promising strategy. This review highlights key advances on the management of chronic refractory sarcoidosis. Novel therapeutic strategies and treatment agents to manage the disease are described.

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Section: Interleukin-17 Blockingmentioning

confidence: 64%

Emerging Molecular Targets for the Treatment of Refractory Sarcoidosis

et al. 2020

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“…When considering future treatment options for PsA, there remains concerns about risk of DISR with other targeted therapies. Secukinumab an IL-17 target that is NICE approved for PsA has been reported in one published case to have caused secukinumab-associated sarcoidosis [ 4 , 7 ]. Tofacitinib is a Janus kinase (JAK) inhibitor that has recently been approved by NICE for the treatment of PsA, and to date there have been no reports of JAK inhibitor-associated sarcoidosis.…”

Section: Discussionmentioning

confidence: 99%

Renal sarcoidosis associated with certolizumab pegol treatment for psoriatic arthritis

Hum

Kanigicherla

2022

Oxford Medical Case Reports

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We present a case of certolizumab-associated renal sarcoidosis, the first reported case in a patient with psoriatic arthritis (PsA) that was effectively treated with corticosteroids. A 55-year-old Caucasian man with PsA diagnosed at age 47 and plaque psoriasis since his early twenties was on certolizumab pegol (CZP) for 7 months before presenting to the emergency department with seizures and renal failure. A renal biopsy confirmed renal sarcoidosis. His CZP therapy was stopped, and after several months taking prednisolone at a reducing regime, his renal function improved, and his PsA remained under control. When considering further treatment options for his PsA keeping in mind that other drugs, especially tumour necrosis factor-alpha inhibitors, have been reported to be associated with sarcoidosis, tofacitinib was considered to be a future treatment option acceptable to the patient, given current National Institute for Health and Care Excellence guidelines approving its use in PsA and the lack of reports of tofacitinib-associated sarcoidosis in the literature.

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“…[1][2][3][4][5][6] To date, there are few reports of sarcoidosis observed with IL-17 inhibitors, four of them occurring with secukinumab. [1][2][3][4][5] Time to onset varied from 3.25 to 19.6 months. 1 There have also been reports of granuloma annulare associated with IL-17 inhibitors.…”

Section: Conflict Of Interestsmentioning

confidence: 99%

“…[1][2][3][4] Dermatological adverse events have been reported in phase II studies including alopecia, palmar-plantar erythrodysesthesia syndrome, stomatitis and nail changes. [1][2][3][4] Nail adverse events, which typically develop within 1-2 months of treatment initiation are typically of mildto-moderate severity. 4 The most reported events have been as follows: onychomadesis, nail discolouration, onycholysis, nails dystrophy, paronychia and onychoclasis.…”

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confidence: 99%