Thomas Subervie, François Sauer, Jean‐Jacques Von Hunolstein, E. Sebbag, Étienne Dahan, Wilhelm Storck, Jacques Éric Gottenberg, Jean Sibilia, Marc Scherlinger
Dear Editor, We present a case of a 56-year-old female patient with a history of psoriatic arthritis diagnosed in 2011. She was initially treated with MTX, followed by a TNF-α inhibitor (TNFi), etanercept (Enbrel®) from 2013 to 2016, which was later stopped due to long-term remission. In 2021, following a relapse of disease activity, adalimumab (Imraldi®) 40 mg every fortnight s.c. was introduced, with disease control. On 3 May 2025, her pharmacist initiated a non-medical switch to another biosimilar (Hyrimoz®). In the following days, the patient reported intermittent dizziness and thoracic oppression. On 17 May, she presented to the emergency department with acute chest pain. The ECG revealed a right bundle branch block with anterior T-wave inversions, suspicious for a non-ST elevation acute coronary syndrome. Laboratory tests showed elevated troponin levels (from 64 ng/l to 207 ng/l at hour 3 and 1400 ng/l at hour 24) with elevated inflammatory markers including a CRP value of 80 mg/l and leucocytosis at 18 × 109/l.