AB0766 SUCCESSFUL TEATMENT OF ANKYLOSING SPONDILITIS ASSOCIATED AA AMYLOIDOSIS WITH SECUKINUMAB: A CASE SERIES WITH THREE PATIENTS

Background: Systemic AA amyloidosis is a serious and life-threatening complication of chronic inflammatory diseases such as rheumatoid arthritis, spondyloarthritis (SpA), periodic fever syndromes. While most common cause Familial Mediterranean Fever; Ankylosing Spondylitis (AS) another frequent in Turkey. Objectives: We aimed to evaluate the response secukinumab (SEC) treatment three patients with AS (AS-AA) our tertiary referral centre. Methods: retrospectively evaluated who fulfilled Modified New York Criteria for diagnosis cohort 163 patients. Diagnosis was confirmed by Congo red stain monoclonal AA-specific antibodies. Results: Patient 1: 61-year-old male patient back pain (IBP) peripheral arthritis 14 years clinic. After methotrexate (MTX) failure, he used adalimumab (ADA), etanercept (ETA) certolizumab (CZP). Nephrotic range proteinuria detected when on CZP, rectum biopsy documented 3 ago. diagnosis, CZP switched infliximab (IFX). IFX ineffective controlling findings. SEC started 15 months ago responded partially. The dose increased 300 mg monthly, which resulted sustained improvement clinical laboratory 2: 69-year-old woman admitted clinic addition history IBP 19 2005. MTX, NSAID prednisolone were started. Because inefficacy conventional treatments development nephrotic proteinuria, ETA added treatment. followed-up 13 without symptoms proteinuria. due secondary two On third month treatment, she developed demyelinating polyneuropathy. still being any findings 3: 49-year-old sulphasalasine 24 ulcerative colitis (UC) recent onset 2007. failure receive IFX. She did not respond first then ADA anti-TNF. Her serum creatinine progressively, haemodialysis (H/D) six later. Due ongoing elevated acute phase Significant observed both no worsening UC. Table 1. Clinical characteristics, responses 1 2 Age (year) 61 69 49 Sex Male Female (year ) 47 35 25 57 50 46 Amyloidosis duration (months 42 168 30 Family No siblings HLA-B 27 status Positive Not available MEFV Negative M694V heterozygous Organ involvement GIS kidney Kidney, liver, heart, bone marrow GIS, Secukinumab 18 CRP (mg/L Before 23 2.4 4.5 2.8 Creatinine (mg/dl 0.5 1.6 H/D 1.3 Proteinuria (g/day 4.2 5.5 0.9 Albumin (g/dL 2.7 2.5 3.1 4.3 ASDAS 4.1 4.6 1.8 1.1 1.7 GIS: Gastrointestinal System, ASDAS: Disease Activity Score Conclusion: rare SpA, found be safe effective AS-AA. Although anti-TNF agents have previously successfully AS-AA, may new option especially are resistant or intolerant anti-TNFs. Disclosure Interests: None declared