A possible case of ulcerative colitis (UC) developed during treatment with ixekizumab is reported. Ixekizumab is a human monoclonal antibody approved for chronic plaque psoriasis that works by blocking interleukin-17 (IL-17). Cytoquines, such as IL-17, may be involved in the pathophysiology of psoriasis and inflammatory bowel diseases. We describe the case of a 76-year-old woman who presented with an episode of acute self-limited colitis after receiving ten doses of ixekizumab. It was resolved after treatment withdrawal. A re-challenge was done after 3 months and symptoms returned. Colonoscopy results confirmed the diagnosis of UC. Symptoms remitted after drug discontinuation and treatment with corticosteroids. Four months after stopping ixekizumab, she remains asymptomatic and she is being treated with guselkumab with adequate response. The Naranjo algorithm revealed a probable causal relationship.This adverse event should be taken into account by physicians and pharmacists before prescribing or reviewing therapies in order to improve patients’ safety.

A possible case of bullous pemphigoid (BP) that developed during treatment with ustekinumab is reported. Ustekinumab is a human monoclonal antibody found in pathologies such as psoriasis, which works by inhibiting the activity of interleukin-12 and interleukin-23. We describe the case of a 75-year-old woman who presented with new onset of erythematous and bullous lesions 5 days after receiving a fifth dose of ustekinumab. The patient was treated with corticosteroids and dapsone, whereupon the lesions disappeared. Ustekinumab was withdrawn. Currently the patient remains asymptomatic. In addition, the histopathological and immunofluorescence findings confirmed the diagnosis of BP. Three causality algorithms were applied and revealed a probable causal relationship. There may be a causal relationship between the use of ustekinumab and BP. This association should be taken into account by physicians when prescribing and reviewing drug therapies.

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Statins are widely used in the treatment of hypercholesterolemia. Muscle weakness and elevated creatine kinase (CK) are frequent side effects of statins with an incidence of about 15%. Statin-associated myopathy is more common in people who receive multiple drugs, the elderly or women but the mechanism underlying it is still unclear. These symptoms generally improve after drug discontinuation. However, there is a type of autoimmune mediated myopathy characterised by the persistence of muscle weakness and CK elevation after stopping statins. Herein, we discuss a case of autoimmune myopathy associated with statin exposure and responsive to immunossupresive drugs. The increased use of statins in recent years raises the importance of acquaintance with this disease in clinical practice.

Background Osteosarcoma is a relatively common bone tumour; with an incidence of 0.2 to 3/100 000, it is an orphan disease. Mifamurtide has managed to increase survival without increasing side effects. PurposeTo evaluate the safety and efficacy of mifamurtide in two paediatric patients diagnosed with osteogenic sarcoma. Materials and MethodsWe conducted a prospective study of two paediatric patients diagnosed with osteogenic sarcoma. Weekly, we attended the oncology sessions and we tracked them during the chemotherapy, and after that, through the electronic clinical history. Mifamurtide is indicated in children, adolescents and young adults for the treatment of high-grade resectable non-metastatic osteosarcoma after surgical resection. It is used in combination with post-operative chemotherapy. In the two cases, the treatment followed the SEOP-SO-2010 guidelines of the Spanish Society of Paediatric Oncology for 37 weeks. After surgery (week 15) mifamurtide was started as adjuvant treatment: 2 mg/m2 twice weekly for the first 12 weeks and followed by once-weekly for an additional 24 weeks, for a total of 48 infusions in 36 weeks. Results Chemotherapy started according to protocol, the patients were aged 12 and 15 years (July and November 2010, respectively). One patient had a flu-like reaction after the first dose of mifamurtide, so the following doses were administered with premedication (acetaminophen and dexchlorpheniramine). Other side effects: anaemia and thrombocytopenia, requiring human stimulating factors and platelet concentrates; vomiting was treated with aprepitant. When chemotherapy finished, the patients were in complete remission, this situation continues today, 10 and 13 months later. Conclusions The SEOP protocol plus mifamurtide achieved complete remission in both cases. The use of mifamurtide can be considered safe and it did not increase side effects, we observed only a flu-like reaction attributed to mifamurtide which resolved with premedication. The effectiveness of mifamurtide in osteogenic sarcoma treatment cannot be considered as assessed due to the small sample size. No conflict of interest.