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In cases not improving with cyclosporine, direct switching to a biological therapy usually leads to a disease flare owing to increased production of interleukin (IL)-17A. Thus, secukinumab, a rapidly acting anti-IL-17A drug, may be ideal in such situations.<\/jats:p>","DOI":"10.1177\/0049475519838400","type":"journal-article","created":{"date-parts":[[2019,4,9]],"date-time":"2019-04-09T21:10:51Z","timestamp":1554844251000},"page":"215-217","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Switching to secukinumab in difficult-to-treat psoriasis recalcitrant to methotrexate, cyclosporine and leflunomide, in a tuberculosis-endemic country"],"prefix":"10.1177","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4057-5365","authenticated-orcid":false,"given":"Aastha","family":"Gupta","sequence":"first","affiliation":[{"name":"Senior Resident, Department of Dermatology, Dr Ram Manohar Lohia Hospital, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kabir","family":"Sardana","sequence":"additional","affiliation":[{"name":"Professor, Department of Dermatology, Dr Ram Manohar Lohia Hospital, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ram K","family":"Gautam","sequence":"additional","affiliation":[{"name":"Professor, Department of Dermatology, Dr Ram Manohar Lohia Hospital, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,4,9]]},"reference":[{"key":"bibr1-0049475519838400","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2005.06893.x"},{"key":"bibr2-0049475519838400","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2010.11.055"},{"key":"bibr3-0049475519838400","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/805705"},{"key":"bibr4-0049475519838400","first-page":"340","volume":"151","author":"Ganzetti G","year":"2016","journal-title":"G Ital Dermatol Venereol"},{"key":"bibr5-0049475519838400","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2011.04033.x"},{"key":"bibr6-0049475519838400","doi-asserted-by":"publisher","DOI":"10.1111\/j.1346-8138.2010.00971.x"},{"key":"bibr7-0049475519838400","first-page":"139","volume":"8","author":"Saitoh K","year":"2016","journal-title":"Biochem Biophy Rep"},{"key":"bibr8-0049475519838400","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.13911"},{"key":"bibr9-0049475519838400","doi-asserted-by":"publisher","DOI":"10.1038\/cti.2017.34"},{"key":"bibr10-0049475519838400","doi-asserted-by":"publisher","DOI":"10.1159\/000345715"},{"key":"bibr11-0049475519838400","doi-asserted-by":"crossref","unstructured":"Saitoh K, Kon S, Nakatsuru T et al. 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