Uveitis – Possible adverse reaction to secukinumab in a patient with rehabilitation treatment for ankylosing spondylitis (case report)

Abstract

Introduction. Ankylosing spondylitis (AS) is a chronic inflammatory disease that predominantly affects the spine, but also peripheral joints, the major characteristic of the disease being the early involvement of the sacroiliac joint. The most common extra skeletal manifestations are ocular disorders and appear to 25-30% of the patients, being more frequent to HLA B27 positive patients. Episodes of previous acute uveitis, known as iridocyclitis, may precede or may occur during or after inflammatory joint manifestations. Materials and Methods. We present a 41-year-old patient diagnosed 11 years ago with Ankylosing spondylitis, on its axial form, without extra-articular manifestations, periodically treated with anti-inflammatory drugs and balneary treatment, but with inefficient clinic and biological response. Since November 2019, his treatment with Secukinumab, started to improve the clinic and paraclinical symptoms. Secukinumab is a fully human monoclonal antibody, the first care that selectively targets IL-17A, an essential cytokine treatment that produces inflammation, and bone remodeling, characteristic of AS. Results. In January 2020, the patient presents increased pain and redness in the right eye area, subsequently diagnosed as anterior acute uveitis. Conclusions. This anterior acute uveitis, may be an extra-articular manifestation in the context of the natural evolution of the disease insufficiently controlled by the recently introduced therapy, or it may be an adverse reaction to Secukinumab, being known that the optic malfunction is a less common side effect. Keywords: Ankylosing Spondylitis, Uveitis, Secukinumab, extra-articular manifestations, rehabilitation, treatment,