RESUMO
Different signaling pathways have been studied in ankylosing spondylitis. New treatment options such as secukinumab could have an important role inhibiting the release of proinflammatory cytokine IL-17. The aim of this study was to compare the efficacy and safety of secukinumab in ankylosing spondylitis. A systematic review was conducted using MEDLINE and EMBASE databases to identify randomized clinical trials (RCTs) that assess the role of secukinumab in ankylosing spondylitis. The variables were safety (total adverse events, serious adverse events, headache, nasopharyngitis, cough, deaths, discontinuation due to adverse events, candida, neutropenia, and diarrhea) and efficacy based on quality-of-life scores (ASAS 20, ASAS 40, ASAS 5/6, ASASPR). Three RCTs (770 patients) that compare secukinumab with placebo were included in the study. There were significant differences in the quality-of-life scores in favor of the secukinumab group (p < 0.05). Regarding the adverse events, there were higher rates of any adverse events in the secukinumab group (p < 0.05). Also, the secukinumab group showed a higher rate of nasopharyngitis and diarrhea (p < 0.05). The use of secukinumab in ankylosing spondylitis increased the quality of life and had more adverse events rate compared with placebo.
Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Anticorpos Monoclonais/uso terapêutico , Interleucina-17/imunologia , Espondilite Anquilosante/tratamento farmacológico , Anticorpos Monoclonais/imunologia , Feminino , Humanos , Interleucina-17/antagonistas & inibidores , Masculino , Qualidade de Vida , Espondilite Anquilosante/imunologia , Resultado do TratamentoRESUMO
OBJECTIVE: To present a case of Hashimoto encephalopathy as a complication of autoimmune thyroiditis. CLINICAL PRESENTATION AND INTERVENTION: A previously healthy 56-year-old female presented with rapidly progressive cognitive decline and visual hallucinations. Being a diagnosis of exclusion, Hashimoto encephalopathy required an extensive laboratory and diagnostic workup, which was done over the course of a 15-day hospitalization. The patient recovered after initial treatment with intravenous methylprednisolone and was then switched to prednisone p.o. CONCLUSION: This case report illustrates the importance of awareness for Hashimoto encephalopathy, as it remains one of the few easily treatable and reversible causes of rapid cognitive decline.
