ABSTRACT:

Psoriatic arthritis (PA) is a chronic autoimmune inflammatory disease characterized by persistent joint inflammation and severe erythemo-squamous plaques on the skin. In recent decades, biological agents such as IL-17 drugs have been applied in the treatment of PA with very good results. The treatment has its adverse effects, but severe pancytopenia is extremely rare. We report a case of а patient who was treated with secukinumab for 3 years and in the background of this treatment unlocked urticaria vasculitis and severe pancytopenia. In relation to psoriatic arthritis, there is almost complete clearing of the skin, but the joint pains are remitting in nature.

KEYWORDS:

psoriasis, psoriatic arthritis, IL-17 biological agents, adverse drug reactions, sekukinumab.

REFERENCES :

1) Dhabale A, Nagpure S. Types of Psoriasis and Their Effects on the Immune System. Cureus. 2022 Sep 24;14(9): e29536. doi: 10.7759/cureus.29536. PMID: 36312680; PMCID: PMC9592057.
2) Aboobacker S, Kurn H, Al Aboud AM. Secukinumab. [Updated 2022 Jul 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537091/
3) Frieder J, Kivelevitch D, Menter A. Secukinumab: a review of the anti-IL-17A biologic for the treatment of psoriasis. Ther Adv Chronic Dis. 2018 Jan;9(1):5-21. doi: 10.1177/2040622317738910. Epub 2017 Nov 16. PMID: 29344327; PMCID:
PMC5761942.
4) https://www.ehealthme.com/ds/cosentyx/pancytopenia/
5) da Silva Cendon Duran C, da Paz AS, Barreto Santiago M. Vasculitis induced by biological agents used in rheumatology practice: A systematic review. Arch Rheumatol. 2021 Dec 24;37(2):300-310. doi: 10.46497/ArchRheumatol.2022.9049. PMID: 36017201; PMCID: PMC9377167.
6) 최상민, 유박린, 심우영, 권순효. (Sang-min Choi), (Bark-lynn Lew), (Woo-young Sim),
(Soon-hyo Kwon Eczematous Vesicular Eruption and Exacerbation of Chronic Spontaneous Urticaria Associated with Secukinumab. Korean Journal of Dermatology 2022; 60(9), 611-614.
7) Galica K, Lesiak A, Ciążyńska M, Noweta M, Bednarski I, Narbutt J. Effectiveness and safety of secukinumab in patients with moderate-to-severe plaque psoriasis – a real life retrospective study. Postepy Dermatol Alergol. 2021 Dec;38(6):973-978. doi: 10.5114/ada.2020.97066. Epub 2020 Jul 11. PMID: 35126003; PMCID: PMC8802960.
8) Egeberg A, Ottosen MB, Gniadecki R, Broesby-Olsen S, Dam TN, Bryld LE, Rasmussen MK, Skov L. Safety, efficacy and drug survival of biologics and biosimilars for moderateto-severe plaque psoriasis. Br J Dermatol. 2018 Feb;178(2):509-519. doi: 10.1111/bjd.16102. Epub 2018 Jan 9. PMID: 29094341.
9) Asawanonda P, Pattamadilok B,Chularojanamontri L, et al. Real-world experience of secukinumab in moderate to severe psoriasis patients in Thailand: Characteristics, effectiveness, and safety. Dermatologic Therapy. 2022;35(12): e15958. doi:
10.1111/dth.15958.
10) Choi S, Oh S, Yoon HS. Association Between Short-Term PASI90 Achievement and Drug Survival of Biologics in Patients with Psoriasis. Ann Dermatol. 2022 Jun;34(3):173-
181. doi: 10.5021/ad.2022.34.3.173. Epub 2022 May 20. PMID: 35721333; PMCID: PMC9171179.
11) Karataş A, Gerçek AN, Öz B, Gözel N, Pişkin Sağır R, Gür M, Koca SS. The effect of secukinumab treatment on hematological parameters in ankylosing spondylitis and psoriatic arthritis. Eur J Rheumatol. 2020 Sep 8;7(4):169–72. doi: 10.5152/eurjrheum.2020.20109. Epub ahead of print. PMID: 32910771; PMCID: PMC7574766.