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Case Reports
. 2018 Feb 15:2018:9679287.
doi: 10.1155/2018/9679287. eCollection 2018.

A Challenging Case of Severe Ulcerative Colitis following the Initiation of Secukinumab for Ankylosing Spondylitis

Dean Ehrlich  1 , Nimah Jamaluddin  1 , Joseph Pisegna  1   2 , David Padua  1   2
Affiliations
Case Reports

A Challenging Case of Severe Ulcerative Colitis following the Initiation of Secukinumab for Ankylosing Spondylitis

Dean Ehrlich et al. Case Rep Gastrointest Med. .

Abstract

Secukinumab is an interleukin-17 inhibitor used for the treatment of ankylosing spondylitis (AS), psoriasis, and psoriatic arthritis. The risk of exacerbating underlying inflammatory bowel disease (IBD) in patients being treated with secukinumab for other conditions is controversial. We document a patient with AS and previously undiagnosed IBD, found to be in a severe ulcerative colitis flare shortly after receiving the loading dose of secukinumab. There are no guidelines regarding biologic salvage therapy for IBD in the setting of active treatment with another biologic agent. After waiting one half-life of secukinumab, our patient had an excellent response to initiation of infliximab.

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Figures

Figure 1
Figure 1
Endoscopic evaluation on presentation. Severe colitis seen throughout the colon.
Figure 2
Figure 2
Endoscopic evaluation after failed trial on oral steroids. Severe colitis seen up to 40 cm; further evaluation was limited given degree of inflammation.
Figure 3
Figure 3
Charted weights. Significant weight loss seen on presentation (blue arrow). Red arrows: indication dates of infliximab administration with the corresponding weight gain.
See this image and copyright information in PMC

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