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The article would like to introduce a psoriatic arthritis (PsA) patient in the Department of Rheumatology of 108 Military Central Hospital. This case of PsA had the secondary tuberculosis infection after Tumor necrotic factor inhibitor (TNFi) treatment, nevertheless the articular destruction caused by PsA still went on. The next management in these patients is always a controversy among the rheumatologists because the lack of international and national recommendation of management step-by-step. In addition, there were not many articles mentioning about this problem. After doctors-patient discussion, patient decided to be administered with Interleukin 17A inhibitor (IL-17Ai) (four doses secukinumab 300mg SC) plus methotrexate, then the disease remission (Minimal disease activity) was achieved without burden of tuberculosis. This success could contribute to the clinical experiences of biologic therapy in patients with severe side effects of TNFi treatment which becomes the more and more popular and causing many difficulties for clinicians.
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