Treatment with secukinumab in multi-comorbid patients with psoriatic arthritis

No evidence-based approaches exist to guide the choice of specific biological agent in patients with psoriatic arthritis (PsA). Case reports may provide useful information to help treatment choice in clinical practice. We report two cases of patients with PsA, one of them with a 14-year-long medical history, and the other with lung involvement. Several different DMARDs with overall modest efficacy and lack of tolerability were used in both cases before switching the patients to secukinumab. Secukinumab allowed for a rapid improvement of the patients' symptoms without any safety concern. Our experience may be useful to the current knowledge on 'real world' use of secukinumab, which appears to effective and safe in challenging patients with comorbidities and poor tolerability to previous used biological agents.