A rare case of drug-induced erectile dysfunction with secukinumab solved after switch to ixekizumab in a psoriatic patient. a case report

Background: Psoriasis is a cutaneous inflammatory condition characterized by an altered turnover of keratinocytes leading to scaly patches. Secukinumab and ixekizumab are two biologic drugs inhibiting interleukin-17. Objective: We report the first case, according to Naranjo score, of a secukinumab-induced erectile dysfunction with severe plaque psoriasis that disappeared after switching to another anti IL17 drug (ixekizumab). Methods: A 45 years old man experienced erectile dysfunction during treatment with an anti-IL17. The adverse effect appeared after 60 days of treatment with secukinumab and rapidly disappeared after discontinuation of the drug. All necessary urologic exams were carried out. Re-administration of secukinumab, due to the exacerbation of psoriasis, caused the same sexual dysfunction after 60 days. Results: Switching to ixekizumab lead to a resolution of the erectile dysfunction and a complete skin clearance. Conclusion: We describe for the first time a sexual dysfunction possibly due to secukinumab and its resolution after the switch to another similar but different drug, highlighting the potential difference between anti-IL17A drugs.