The use of secukinumab in an HIV-positive patient with axial spondyloarthritis: a case-based review

Axial spondyloarthritis in HIV-positive patients raises specific treatment challenges as immunosuppressant and immunomodulating agents may adversely affect the course of the HIV infection and could increase the risk of opportunistic infections. The efficacy and safety of secukinumab in patients with HIV is unknown due to HIV patients were largely excluded from clinical trials and nowadays, the clinical evidence for the treatment with biological disease-modifying antirheumatic drugs (DMARDs) is provided from scarce case reports and case series. We hereby discuss a case of a male patient with concomitant axial spondyloarthritis and HIV infection successfully treated with secukinumab, achieving disease remission and without any associated complications. Nevertheless, the potential long-term effects in the use of monoclonal antibodies with a special emphasis on opportunistic infections, malignancies, and loss of HIV control clearly need to be determined more thoroughly, and continued research efforts are necessary before a clear recommendation can be made.