Efficacy of secukinumab in Takayasu arteritis with myocardial infarction complicated with generalized pustular psoriasis: A case report.

RATIONALE

Takayasu arteritis (TAK) is an autoimmune disease that causes chronic inflammation targeting the aortic wall. Since many patients are resistant to steroid treatment, multiple immunosuppressants or interleukin-6 (IL-6) suppression therapy have served as treatment alternatives. However, there are very few reports on the effectiveness of biologics against inflammatory cytokines upstream of IL-6.

PATIENT CONCERNS

We present a case of TAK in a 51-year-old female presenting with a myocardial infarction. She had persistent carotid wall thickening despite glucocorticoid (GC) therapy, and IL-6 suppression therapy was being proactively considered. While the GC was being tapered, widespread pustules appeared all over her body.

DIAGNOSIS

TAK complicated with generalized pustular psoriasis (GPP).

INTERVENTIONS

Aside from GC, the patient was treated with secukinumab (SEC), an anti-IL-17A monoclonal antibody.

OUTCOMES

Immediately after treatment with SEC, the pustules disappeared, and the thickening of the common carotid artery wall improved on ultrasound.

LESSONS

Since IL-17 is an important cytokine in the pathogenesis of TAK, anti-cytokine therapy targeting IL-17 may be effective for TAK.