Secukinumab-induced Raynaud’s phenomenon: first report in the literature

Secukinumab is an IL-17A antagonist that has proven efficacy in the treatment of patients with ankylosing spondylitis (AS) and psoriatic arthritis. Side effects of the drug include infections, skin rashes, and allergic reactions. Raynaud’s phenomenon (RP), a vasospastic syndrome and an important feature of different connective tissue diseases, is not an expected finding in AS patients. This article reports the development of secukinumab-related RP in a 35-year-old female patient with AS. Treatment with secukinumab was continued and RP was treated with low-dose aspirin and a calcium-channel blocker.

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POS1319 RAYNAUD’S PHENOMENON IN A SINGLE CENTER COHORT OF TURKISH CHILDREN

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.3076 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 942.1-942

Author(s):

Ş. Çağlayan ◽

F. Demir ◽

B. Sancar ◽

K. Ulu ◽

T. Coşkuner ◽

...

Keyword(s):

Low Dose ◽

Pediatric Patients ◽

Clinical Presentation ◽

Raynaud’S Phenomenon ◽

Raynaud's Phenomenon ◽

Calcium Blockers ◽

Color Changes ◽

Dose Aspirin ◽

Low Dose Aspirin ◽

Disease Associations

Background:Raynaud’s phenomenon (RF) is a vasospastic condition characterized by episodic color changes of blanching, cyanosis, and hyperemia of the extremities of the bodyObjectives:We aim to examine the clinical presentation, capillaroscopic findings and disease associations of Raynaud’s phenomenon (RP) in pediatric patientsMethods:We retrospectively enrolled a single-center cohort of 247 consecutive pediatric patients with RP admitted to Umraniye Training and Research Hospital, Pediatric Rheumatology Clinic, Istanbul, Turkey, since 2016. Medical records were analyzed for clinical presentation, disease associations, and physical examination and laboratory findings.Results:We reported 247 patients (152 female, 95 male) with RP. Their mean age at disease onset was 14.5±2.55 years and median age at diagnosis was 15.4± 2.21 years. In patients with secondary RP syndrome (10.9%), the age of complaint was found to be lower than others (p=0.03). Although most patients have affected upper extremity (hand and fingers), lower extremity (toes) involvement was also detected in 50 (20%) patients. In both the patients with primary and secondary RP, main triggering factor was found as cold exposure. Biphasic (53.6%) color changes were more seen in primary RP, although triphasic (51.8%) color changes were more in patients with secondary RP (p=0.00). The presence of antinuclear antibodies and abnormal nailfold capillaries were more seen in patients with secondary RP (28% vs 74% and 35.3% vs 66.7, respectively p=0.00). Digital ulcer was detected 5.2% of patients (mostly secondary). Out of 247, 31 patients were treated with low-dose aspirin, 47 with calcium blockers, 25 with low-dose aspirin and calcium blockers, 16 with iloprost and/or bosentan, while the remaining 140 did not receive any drug.Conclusion:Similar to adults, RP is more common in girls without an underlying disease. In patients with secondary RP, the symptoms. It has been shown that in patients with secondary RP, symptoms begin at a younger age and the ANA positivity and abnormal nailfold capillaries correlate.References:[1]Jones G, et al. Arthritis Rheum 2003;48:3518–352[2]Garner R et al. BMJ Open. 2015; 5(3): e006389[3]Nigrovic PA et al. Pediatrics 2003, 111 (4) 715-721Disclosure of Interests:None declared

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Esomeprazole Lessened Ulcer Risk For Patients on Low-Dose Aspirin

Internal Medicine News ◽

10.1016/s1097-8690(06)73895-1 ◽

2006 ◽

Vol 39 (14) ◽

pp. 52

Author(s):

Doug Brunk

Keyword(s):

Low Dose ◽

Dose Aspirin ◽

Low Dose Aspirin

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Alert Issued on Low-Dose Aspirin + Ibuprofen

Clinical Psychiatry News ◽

10.1016/s0270-6644(06)71782-9 ◽

2006 ◽

Vol 34 (10) ◽

pp. 8

Author(s):

ELIZABETH MECHCATIE

Keyword(s):

Low Dose ◽

Dose Aspirin ◽

Low Dose Aspirin

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Benefits of Low-Dose Aspirin Alone Offset Costs

Family Practice News ◽

10.1016/s0300-7073(07)71179-9 ◽

2007 ◽

Vol 37 (19) ◽

pp. 11

Author(s):

KERRI WACHTER

Keyword(s):

Low Dose ◽

Dose Aspirin ◽

Low Dose Aspirin

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Investigation of the Interaction of Blood Platelets with the Coagulation System at the Site of Plug Formation In Vivo in Man - Effect of Low-Dose Aspirin

Thrombosis and Haemostasis ◽

10.1055/s-0038-1651063 ◽

1987 ◽

Vol 57 (01) ◽

pp. 062-066 ◽

Cited By ~ 36

Author(s):

P A Kyrle ◽

J Westwick ◽

M F Scully ◽

V V Kakkar ◽

G P Lewis

Keyword(s):

Platelet Activation ◽

Thrombin Generation ◽

Low Dose ◽

Bleeding Time ◽

Blood Platelets ◽

Dose Aspirin ◽

Low Dose Aspirin ◽

Plug Formation ◽

Granule Release

SummaryIn 7 healthy volunteers, formation of thrombin (represented by fibrinopeptide A (FPA) generation, α-granule release (represented by β-thromboglobulin [βTG] release) and the generation of thromboxane B2 (TxB2) were measured in vivo in blood emerging from a template bleeding time incision. At the site of plug formation, considerable platelet activation and thrombin generation were seen within the first minute, as indicated by a 110-fold, 50-fold and 30-fold increase of FPA, TxB2 and PTG over the corresponding plasma values. After a further increase of the markers in the subsequent 3 minutes, they reached a plateau during the fourth and fifth minute. A low-dose aspirin regimen (0.42 mg.kg-1.day-1 for 7 days) caused >90% inhibition of TxB2formation in both bleeding time blood and clotted blood. At the site of plug formation, a-granule release was substantially reduced within the first three minutes and thrombin generation was similarly inhibited. We conclude that (a) marked platelet activation and considerable thrombin generation occur in the early stages.of haemostasis, (b) α-granule release in vivo is partially dependent upon cyclo-oxygenase-controlled mechanisms and (c) thrombin generation at the site of plug formation is promoted by the activation of platelets.

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Increased Thromboxane Biosynthesis in Essential Thrombocythemia

Thrombosis and Haemostasis ◽

10.1055/s-0038-1649916 ◽

1995 ◽

Vol 74 (05) ◽

pp. 1225-1230 ◽

Cited By ~ 71

Author(s):

Bianca Rocca ◽

Giovanni Ciabattoni ◽

Raffaele Tartaglione ◽

Sergio Cortelazzo ◽

Tiziano Barbui ◽

...

Keyword(s):

Platelet Count ◽

Platelet Activation ◽

Essential Thrombocythemia ◽

Therapeutic Strategy ◽

Low Dose ◽

Thrombotic Risk ◽

Dose Aspirin ◽

Gender And Age ◽

Low Dose Aspirin

SummaryIn order to investigate the in vivo thromboxane (TX) biosynthesis in essential thromboeythemia (ET), we measured the urinary exeretion of the major enzymatic metabolites of TXB2, 11-dehydro-TXB2 and 2,3-dinor-TXB2 in 40 ET patients as well as in 26 gender- and age-matched controls. Urinary 11-dehydro-TXB2 was significantly higher (p <0.001) in thrombocythemic patients (4,063 ± 3,408 pg/mg creatinine; mean ± SD) than in controls (504 ± 267 pg/mg creatinine), with 34 patients (85%) having 11-dehydro-TXB2 >2 SD above the control mean. Patients with platelet number <1,000 × 109/1 (n = 25) had significantly higher (p <0.05) 11 -dehydro-TXB2 excretion than patients with higher platelet count (4,765 ± 3,870 pg/mg creatinine, n = 25, versus 2,279 ± 1,874 pg/mg creatinine, n = 15). Average excretion values of patients aging >55 was significantly higher than in the younger group (4,784 ± 3,948 pg/mg creatinine, n = 24, versus 2,405 ± 1,885 pg/mg creatinine, n = 16, p <0.05). Low-dose aspirin (50 mg/d for 7 days) largely suppressed 11-dehydro-TXB2 excretion in 7 thrombocythemic patients, thus suggesting that platelets were the main source of enhanced TXA2 biosynthesis. The platelet count-corrected 11-dehydro-TXB2 excretion was positively correlated with age (r = 0.325, n = 40, p <0.05) and inversely correlated with platelet count (r = -0.381, n = 40, p <0.05). In addition 11 out of 13 (85%) patients having increased count-corrected 11-dehydro-TXB2 excretion, belonged to the subgroup with age >55 and platelet count <1,000 × 1099/1. We conclude that in essential thrombocythemia: 1) enhanced 11-dehydro-TXB2 excretion largely reflects platelet activation in vivo;2) age as well as platelet count appear to influence the determinants of platelet activation in this setting, and can help in assessing the thrombotic risk and therapeutic strategy in individual patients.

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