Secukinumab in the treatment for patients with juvenile enthesitis related arthritis non-responsive to anti-TNF treatment according the Juvenile Spondyloarthritis Disease Activity Index.

OBJECTIVES: To review the effectiveness of secukinumab (SEC) in patients with juvenile idiopathic enthesitis related arthritis (ERA), who had partial or no response on anti-TNF therapy. METHODS: We conducted a retrospective monocentric chart review of patients with ERA, who were treated with SEC, until March 15th 2019. We used the JADAS10 and the Juvenile Spondyloarthritis Disease Activity Index (jspADA) to evaluate response. We analysed the onset of AE and SAE. RESULTS: We analysed 17 patients with ERA. The mean age at the start of the treatment was 19.5 years (SD 4.9, range 13-34 years, median 18.2). The mean disease duration was 6.3 years (SD 3.3, range 2-12 years). The patients received in average 1.9 (SD1.0) different anti-TNF'́s before switching to SEC. SEC was applied at the start of the treatment with 150 mg per dose (n=13, 76.5%) and 300 mg per dose (n=4, 23.5%). The dose of 150 mg was increased in 11 patients (85% of 13) after baseline. The mean follow-up of patients was 18.2 months (SD 7.2) accounting to 25.8 years under exposure to SEC. The jspADA (mean change of -1.3; p<0.001; 95%CI: -1.9 to -0.7) and JADAS10 (mean change of -2.4; p=0.021; 95%CI: -4.5 to -0.4) signi cantly improved between baseline and the 24-month follow-up. There was no serious adverse event observed. CONCLUSIONS: In our anti-TNF non-responder patients SEC showed good effectiveness. The 150 mg dose seems to be insufficient in anti-TNF non-responder patients and most patients had to be escalated to the 300 mg/dose.

Human diphyllobothriasis in Peru

Diphyllobothrium pacificum, a tapeworm from seals, is reported for the first time from man in Peru. Seven further cases are described from people living along the coast and whose food includes various species of sea fish. The very complicated history of the parasite which involves numerous synonyms has been established. This is also first report of human diphyllobothriasis other than D. latum from the Southern Hemisphere.

Diphyllobothrium pacificum, un cestode d’otaries, est signalé pour la premiére fois chez l’homme au Pérou. Sept nouveaux cas sont décrits chez des personnes habitant la region côtiére et mangeant du poisson marin. L’histoire trés compliquée de c ever impliquant de nombreux synonymes, a été établie. C’est également la premiére fois que l’on signale une diphyllobothriase humaine autre que D. latum dans l’Hémisphére Sud.

Diphyllobothrium pacificum, un céstodo de las otarias, es señalado por la primera vez como parásito humano en el Perú. Siete casos más son descritos en los habitantes de la costa en cuya alimentación entra el pescado de mar. Se ha podido establecer la historia muy complicada de este helminto, la cual implica una multitud de sinónimos. Es igualmente la primera vez que se ha señalado una difilobotriasis humana en el Hemisferio Sur que no sea causada por el D. latum.