Paradoxical flare of psoriasis, psoriatic spondyloarthritis, and psoriatic uveitis after switching from infliximab to secukinumab

Su, Peiqi; Pan, Jiun Yit

doi:10.1016/j.dsi.2016.10.002

Cited by 10 publications

(4 citation statements)

References 7 publications

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“…In our review, 37 patients (20.7%) had exacerbation of preexisting PsA [ 7 – 10 , 26 , 27 , 29 , 31 , 40 , 44 , 46 , 52 , 57 , 62 – 64 , 67 , 71 , 74 , 77 , 84 , 85 ], 113 patients (63.1%) had new-onset PsA [ 11 , 13 , 15 , 16 , 20 , 24 , 25 , 28 , 35 , 38 , 39 , 41 , 43 , 47 , 48 , 50 – 53 , 57 , 60 – 62 , 65 – 68 , 70 , 72 , 73 , 75 , 76 , 78 , 80 ], 28 patients (15.6%) had de novo psoriatic skin and joint disease [ 10 , 12 , 14 , 17 – 19 , 21 – 23 , 30 , 32 – 34 , 36 , 37 , 42 , 45 , 46 , 54 – 56 , 58 , 79 , 81 – …”

Section: Resultsmentioning

confidence: 93%

“…More than half (48/94, 51.1%) of these events involved ustekinumab treatment [ 57 , 60 , 62 , 63 , 65 – 67 , 72 , 74 , 75 , 77 , 78 ], and tumor necrosis factor (TNF)-inhibitors accounted for another 39.4% (37/94) [ 56 , 58 , 61 , 65 , 66 , 68 , 70 , 72 , 79 , 80 ]. The remaining 10% belong to five novel biologics that target the Th17/IL-23 pathway [ 64 , 71 – 73 , 76 ]. Most patients received biologic treatment for long-standing psoriasis, and only three patients with no personal history of psoriasis developed psoriasis and PsA after TNF-inhibitors treatment [ 56 , 58 , 79 ].…”

Section: Resultsmentioning

confidence: 99%

“…The latency period after introduction ranged from immediately after the first dose of biologics to 48 months afterward. Half of these patients continued biologic treatment with methotrexate or steroid for arthritis control [ 72 ], and three patients switched biologics [ 64 , 73 , 76 ].…”

Section: Resultsmentioning

confidence: 99%

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Drug- or Vaccine-Induced/Aggravated Psoriatic Arthritis: A Systematic Review

Yeh,

Tsai

2024

Dermatol Ther (Heidelb)

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Introduction Drugs and vaccines have been less studied as inducing or aggravating factors for psoriatic arthritis (PsA) compared with psoriasis. Thus, the present study collected and summarized the publications to date about this issue. Methods We conducted a systematic literature search through the PubMed, Embase, and Cochrane databases to identify all reports on potential drug- and vaccine-related PsA events until 28 February 2023. Results In total, 179 cases from 79 studies were eligible for study. Drugs commonly reported include coronavirus disease 2019 (COVID-19) mRNA vaccines (6 cases), bacillus Calmette–Guerin (BCG) vaccine (3 cases), interferon (18 cases), immune-checkpoint inhibitors (ICI) (19 cases), and biologic disease-modifying antirheumatic drugs (bDMARDs) (127 cases). Drugs causing psoriasis may also induce or aggravate PsA (6 cases). BDMARD-related PsA mostly occurred in a “paradoxical” setting, in which the bDMARDs approved for the treatment of psoriasis induce or aggravate PsA. The reported latency may be delayed up to 2 years. Peripheral arthritis (82.3%) was the most common manifestation of drug- and vaccine-related PsA, followed by dactylitis (29.1%), enthesitis (23.4%), and spondyloarthritis (17.7%). Conclusions Drugs and vaccines may be implicated in the aggravation of PsA. Possible mechanisms include cytokine imbalance, immune dysregulation, or inadequate PsA treatment response compared with psoriasis. Most reports are case based without controls, so more studies are needed to further prove the causality. However, early recognition of factors causing or aggravating PsA is important to prevent the irreversible joint damage. Supplementary Information The online version contains supplementary material available at 10.1007/s13555-023-01082-z.

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Section: Resultsmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 99%

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Drug- or Vaccine-Induced/Aggravated Psoriatic Arthritis: A Systematic Review

Yeh,

Tsai

2024

Dermatol Ther (Heidelb)

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“…There is, however, one reported case of a paradoxical flare of psoriatic uveitis after switching from infliximab to secukinumab. 9 This sheds light on the possibility that anti-IL17 drugs may also be associated with paradoxical worsening of disease including uveitis. The incidence rate of uveitis (new-onset and flares) is low 1.4 patient-year in a pooled analysis of 3 randomized control trials for secukinumab.…”

Section: Discussionmentioning

confidence: 96%

<p>New-Onset Uveitis Possibly Caused by Secukinumab in a 47-Year-Old Male Patient with Long-Standing Ankylosing Spondylitis</p>

Nadwi

Janaini

Zammo

et al. 2020

IMCRJ

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Secukinumab, “an IL-17 antagonist”, is one of the biological agents used to treat active ankylosing spondylitis (AS). Although it has been proven that certain agents are linked with a paradoxical increase in uveitis, there are limited data on whether secukinumab has this effect or not. We report a case of a new-onset anterior uveitis after 6 months of starting secukinumab in a 47-year-old male, HLA-B27 positive AS patient. He had a long-standing history with the disease over 25 years. He was treated in the past with methotrexate then adalimumab and later on with etanercept. He had no history of uveitis during all of this time. The uveitis was mild and treated conventionally with local measures while secukinumab was maintained. After a close follow-up, the uveitis had completely resolved. Is this part of the original disease or a possible side effect from secukinumab?

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