{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T10:00:10Z","timestamp":1762941610703,"version":"3.45.0"},"reference-count":13,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,10,20]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:p>Patients with ankylosing spondylitis (AS) may require biological therapy, particularly tumour necrosis factor (TNF) inhibitors, which are effective but increase the risk of tuberculosis (TB). Secukinumab, an interleukin-17A inhibitor, has not been linked to TB reactivation; however, its safety in the setting of active TB remains unclear. We report two patients with AS who developed active TB during long-term anti-TNF treatment. Both experienced disease flares while receiving anti-TB therapy and needed alternative biologic treatment. Secukinumab was started 2\u2009months after initiating standard four-drug TB therapy and achieved rapid and sustained control of AS activity without compromising TB management. Both patients completed 9\u2009months of anti-TB treatment without adverse events or TB reactivation during 1 year follow-up. These observations suggest that secukinumab may be a safe and effective therapeutic option for patients with AS with concomitant active TB when anti-TNF agents are contraindicated, though confirmation in larger studies is warranted.<\/jats:p>","DOI":"10.1136\/bcr-2025-265465","type":"journal-article","created":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T09:55:15Z","timestamp":1762941315000},"page":"e265465","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Treatment experience with secukinumab in two patients with ankylosing spondylitis and concomitant active tuberculosis"],"prefix":"10.1136","volume":"18","author":[{"given":"Fatih","family":"Albayrak","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Gaziantep University, Gaziantep, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nurcihan Y","family":"Sava\u015f","sequence":"additional","affiliation":[{"name":"Department of Radiology, Sanko University, Gaziantep, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melis","family":"Mutlu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hacettepe University, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5105-0292","authenticated-orcid":false,"given":"Zeynel A","family":"Sayiner","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Sanko University, Gaziantep, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bunyamin","family":"Kisacik","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Sanko University, Gaziantep, 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