a Psoriasis Area Severity Index 100 response) with no adverse event and no evidence of progression of the neurological disease either

a Psoriasis Area Severity Index 100 response) with no adverse event and no evidence of progression of the neurological disease either. strong class=”kwd-title” Keywords: Psoriasis, Ixekizumab, Multiple Sclerosis, Case Report, Spain Multiple sclerosis (MS) is an autoimmune demyelinating disorder of the central nervous system. psoriasis such as the overexpression of GLYX-13 (Rapastinel) Th17 lymphocytes and associated cytokines.1,2 We report the case of a patient presenting with MS and severe psoriasis who was successfully treated with ixekizumab (anti-IL-17A and IL-17A/F monoclonal antibody). To the best of the authors knowledge, this is the first case of its kind to be reported in the medical literature. Case Report We report a 50-year-old male patient with a 40-year history of chronic plaque psoriasis who presented to Hospital Virgen de la Victoria, Mlaga, Spain, in 2019. He was diagnosed with this in 1979 along with primarily progressive MS which made the patient dependent on GLYX-13 (Rapastinel) others for his basic daily activities. His usual medications included muscle relaxants such as baclofen (25 mg every 12 h) and tizanidine hydrochloride (2 mg every 12 h). His psoriasis had been initially treated with methotrexate and acitretin and then switched to ustekinumab (45 mg) due to the inefficacy of the former. However, a GLYX-13 (Rapastinel) Psoriasis Area Severity Index (PASI) of 14 persisted after increasing the dose of ustekinumab GLYX-13 (Rapastinel) to 90 mg every eight weeks [Physique 1]. Open in a separate window Physique 1 Baseline photographs of the chest and legs of a 50-year-old male patient with multiple sclerosis and plaque psoriasis at the time of starting treatment with ixekizumab. Due to the MS, for which the use of anti-tumor necrosis factor (TNF) alpha biological agents is not indicated, the treatment was changed to include ixekizumab (80 mg), following the dosage instructions provided in the drugs datasheet. After four weeks, the patient presented with a PASI of 3 [Physique 2]. GLYX-13 (Rapastinel) Open in a separate window Physique 2 Photographs of the chest and legs of a 50-year-old male patient with multiple sclerosis and plaque psoriasis four weeks after the start of treatment with ixekizumab. During the subsequent follow-ups, the patient achieved complete skin clearance (PASI 100 response) and this is maintained at the time of writing this report, i.e. three years after the initiation of the ixekizumab (80 mg) treatment. Moreover, no adverse events occurred during this follow-up period and laboratory investigations were normal. As for MS, the disease remains stable with no new symptoms or signs of progression after starting the ixekizumab treatment. The patient signed a written consent to permit the publishing Rabbit Polyclonal to Claudin 1 of his clinical data and photographs. Discussion Pathogenic mechanisms of MS have not yet been sufficiently comprehended. An autoimmune aetiology must be considered, but genetic and environmental factors may play a role. Regarding these immune factors, the roles played by T helper Type 1 (Th1), Th17, CD8+ T cells and macrophages stand out as they attack the proteins that form the myelin sheaths of the central nervous system. This provides the needed scope for a connection being established between psoriasis and MS as they share, at least partially, similar immunopathogenic mechanisms such as the overexpression of the Th17 pathway. The evidence concerning this is strong as multiple studies have pointed to the involvement of Th17 lymphocytes and their cytokines in the immunopathogenesis of MS.2C4 Recently, Li em et al /em . published a meta-analysis, wherein they found an increase in the proportion of peripheral blood Th17 cells and IL-17 and IL-23 levels in patients with MS when compared with healthy subjects.2 This fact, together with the increased risk of incident psoriasis in patients with MS (amounting to a 54% higher risk than in the healthy population), or the existence of drugs approved for both diseases, such as fumarate, suggests that there is a degree of overlap in the immunopathogenic mechanisms of both these diseases.5,6 However, there are also.

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