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11-10-2017 | Psoriatic arthritis | Case report | Article

A Case of Recalcitrant Psoriatic Arthritis to TNF Inhibitors Improved After Administration of Secukinumab, an IL-17A Inhibitor

Journal: Rheumatology and Therapy

Authors: Eleftherios Pelechas, Tereza Memi, Paraskevi V. Voulgari, Alexandros A. Drosos

Publisher: Springer Healthcare

Abstract

Psoriatic arthritis (PsA) is a unique inflammatory arthritis due to the fact that patients have to deal not only with pain but also with their skin appearance, which may have a detrimental effect on their everyday lives and psychology. Treating a patient with PsA, improving both the musculoskeletal and skin symptoms is a challenge for the clinical rheumatologist. In this case, we present a patient of recalcitrant PsA to tumor necrosis factor inhibitors (TNFi) who had an exceptional improvement after administration of the interleukin-17A inhibitor (IL-17Ai) secukinumab.

Nikas SN, Voulgari PV, Takalou IP, Katsimbri P, Drosos AA. Healing of psoriatic skin lesions, and improvement of psoriatic arthritis resistant to immunosuppressive drugs, after infliximab treatment. Ann Rheum Dis. 2005;64(11):1665–7. doi:10.1136/ard.2005.036178.CrossRefPubMedPubMedCentral

Wollina U, Conrad H. Treatment of recalcitrant psoriatic arthritis with anti-tumor necrosis factor-alpha antibody. J Eur Acad Dermatol Venereol. 2002;16(2):127–9. doi:10.1046/j.1468-3083.2002.00391.x.CrossRefPubMed

Nash P, Clegg DO. Psoriatic arthritis therapy: NSAIDs and traditional DMARDs. Ann Rheum Dis. 2005;64(Suppl ii):74-ii77. doi:10.1136/ard.2004.030783.CrossRef

de Vlam K, Lories RJ. Remission in psoriatic arthritis. Curr Rheumatol Rep. 2008;10(4):297–302.CrossRef

Atteno M, Peluso R, Costa L, Padula S, Iervolino S, Caso F, Sanduzzi A, Lubrano E, et al. Comparison of effectiveness and safety of infliximab, etanercept, and adalimumab in psoriatic arthritis patients who experienced an inadequate response to previous disease-modifying antirheumatic drugs. Clin Rheumatol. 2010;29(4):399–403. doi:10.1007/s10067-009-1340-7.CrossRefPubMed

Kristensen LE, Gulfe A, Saxne T, Geborek P. Efficacy and tolerability of anti-tumour necrosis factor therapy in psoriatic arthritis patients: results from the South Swedish Arthritis Treatment Group register. Ann Rheum Dis. 2008;67(3):364–9. doi:10.1136/ard.2007.073544.CrossRefPubMed

Saougou I, Markatseli TE, Papagoras C, Voulgari PV, Alamanos Y, Drosos AA. Sustained clinical response in psoriatic arthritis patients treated with anti-TNF agents: a 5-year open-label observational cohort study. Semin Arthritis Rheum. 2011;40(5):398–406. doi:10.1016/j.semarthrit.2010.07.004.CrossRefPubMed

Mease PJ, Goffe BS, Metz J. Etanercept in the treatment of psoriatic arthritis and psoriasis: a randomised trial. Lancet. 2000;356(9227):385–90. doi:10.1016/S0140-6736(00)02530-7.CrossRefPubMed

Kotsis K, Voulgari PV, Tsifetaki N, Machado MO, Carvalho AF, Creed F, et al. Anxiety and depressive symptoms and illness perceptions in psoriatic arthritis and associations with physical health-related quality of life. Arthritis Care Res. 2012;64(10):1593–601. doi:10.1002/acr.21725.CrossRef

10.

Lamb RC, Matcham F, Turner M, Rayner L, Simpson A, Hotopi M, et al. Screening for anxiety and depression in people with psoriasis: a cross-sectional study in a tertiary referral setting. Br J Dermatol. 2017;176(4):1028–34. doi:10.1111/bjd.14833.CrossRefPubMed

11.

McInnes I, Sieper J, Braun J, Emery P, Van Der Heijde D, Isaacs J, Dahmen G. Anti-interleukin 17A monoclonal antibody secukinumab reduces signs and symptoms of psoriatic arthritis in a 24-week multicenter, double-blind, randomized, placebo-controlled trial. Arthritis Rheum. 2011;63(10):306.

12.

Kurosaki Y, Takamori K, Suga Y. Refractory psoriasis vulgaris with itching successfully treated with the anti-interleukin-17A antibody secukinumab: a case of secondary failure of other biologic agents. Indian J Dermatol. 2017;62(4):441.PubMedPubMedCentral

13.

Mease PJ, McInnes IB, Kirkham B, Kavanaugh A, Rahman P, Heijde D, Landewe R, Nash P, Pricop L, Yuan J, Richards HB, Mpofu S. Secukinumab inhibition of interleukin-17A in patients with psoriatic arthritis (for the FUTURE 1 study group). N Eng J Med. 2015;373(14):1329–39. doi:10.1056/NEJMoa1412679.CrossRef

14.

McInnes IB, Mease PJ, Kirkham B, Kavanaugh A, Ritchlin CT, Rahman P, Heijde D, Landewe R, Conaghan PG, Gottlieb AB, Richards H, Pricop L, Ligozio G, Patekar M, Mpofu S. Secukinumab, a human anti-interleukin-17A monoclonal antibody, in patients with psoriatic arthritis (FUTURE 2): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2015;386(9999):1137–46. doi:10.1016/S0140-6736(15)61134-5.CrossRefPubMed

15.

Gutowska-Owsiak D, Schaupp AL, Salimi M, et al. IL-17 downregulates filaggrin and affects keratinocyte expression of genes associated with cellular adhesion. Exp Dermatol. 2012;21(2):104–10.CrossRef

Medicine Matters Rheumatology

Abstract