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.