Asymptomatic Crohn’s disease identified in a patient being treated with secukinumab: A case report

Haidari, Wasim; Al-Naqshabandi, Sarah M.; Ahn, Christine S.; Bloomfeld, Richard S.; Feldman, Steven R.

doi:10.1177/2050313x19893580

Cited by 8 publications

(17 citation statements)

References 13 publications

(13 reference statements)

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“…A total of 29 studies were identified in the published literature, including 25 case reports ( Ehrlich et al, 2018 ; Grimaux et al, 2018 ; Paul et al, 2018 ; Wang et al, 2018 ; Achufusi et al, 2019 ; Grossberg, 2019 ; Haidari et al, 2019 ; Johnston and Veettil, 2019 ; Philipose et al, 2019 ; Rodriguez et al, 2019 ; Shimizu et al, 2019 ; Smith et al, 2019 ; Darch et al, 2020 ; Fieldhouse et al, 2020 ; Marin et al, 2020 ; Merino Gallego et al, 2020 ; Nazarian et al, 2020 ; Ali et al, 2021 ; Mu et al, 2021 ; Obeidat and Murakami, 2021 ; Ma et al, 2022 ; Sykaras et al, 2022 ; Kukol et al, 2019 ; Nallapeta et al, 2019 ; Sethi et al, 2019 ) and 4 case series ( Fobelo et al, 2018 ; Shukla et al, 2018 ; Vernero et al, 2019 ; Lee et al, 2020 ); a total of 34 cases raised evidence of IBD occurrence during therapy with SEC (27 cases, 79.4%) and IXE (7 cases, 20.6%). Characteristics of the included cases are presented in Table 4 .…”

Section: Resultsmentioning

confidence: 99%

IL-17 inhibitor-associated inflammatory bowel disease: A study based on literature and database analysis

Deng

Wang

et al. 2023

Front. Pharmacol.

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Objective: Few real-world studies have shown clear association between interleukin (IL)-17 inhibitors and inflammatory bowel disease (IBD) onset. This study investigated the reporting prevalence and evaluated the clinical features and management of IL-17 inhibitor-related IBD events.Methods: We used the US FDA Adverse Event Reporting System database and retrieved data, from 2015 to 2022, on IL-17 inhibitors to identify gastrointestinal inflammatory events and conduct disproportionality analyses by estimating the reporting odds ratios (RORs) and corresponding 95% confidence intervals (CIs). Furthermore, case reports and case series, from 2015 to 30 November 2022, on IBD induced by IL-17 inhibitors were collected for retrospective analysis.Results: A total of 388 cases of primary suspected IL-17 inhibitor-associated gastrointestinal events were reported (268 IBD and 120 colitis), including 348 cases involving secukinumab (SEC), 36 cases involving ixekizumab (IXE), and 4 cases involving brodalumab (BRO). Statistically significant reporting rates of total IBD events were observed for SEC and IXE (ROR = 2.13, 95% CI [1.96-2.30] and ROR = 2.79, 95% CI [2.39-3.27], respectively), whereas BRO did not trigger a safety signal. Twenty-nine studies, which included 34 cases, showed evidence of IBD, following SEC (79.4%) and IXE (20.6%) treatment. The median age was 42 years; typical initial symptoms included diarrhea (90.9%), abdominal pain (57.6%), bloody diarrhea (51.5%), and fever (36.4%). The median time to onset of IBD symptoms was 2.9 months. Some cases were accompanied by elevated white blood cell (WBC) count (87.5%), erythrocyte sedimentation rate (ESR; 85.7%), C-reactive protein (CRP; 100%), and fecal calprotectin (FC; 100%). Cessation of IL-17 inhibitors plus treatment with corticosteroids and TNF antagonists, as either monotherapy or in combination, could lead to complete clinical remission. The median time to remission after IL-17 inhibitor discontinuation was 4 weeks.Conclusion: IL-17 inhibitor treatment is associated with exacerbation and new onset of IBD and colitis. Obtaining a detailed patient history before initiation of treatment and monitoring gastrointestinal symptoms and intestinal inflammatory biomarkers during IL-17 inhibitor treatment is important for safe use of these drugs.

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Section: Resultsmentioning

confidence: 99%

IL-17 inhibitor-associated inflammatory bowel disease: A study based on literature and database analysis

Deng

Wang

et al. 2023

Front. Pharmacol.

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“…In a phase 2 randomized clinical trial of another anti‐IL‐17 agent, brodalumab, CD worsening was also detected at a higher rate in the anti‐IL‐17 treatment group compared with the placebo group (25.0% vs. 6.3%), leading to the early termination of the study 13,14 . In addition to the clinical trial on secukinumab multiple case reports have emerged reporting patients who developed IBD while on secukinumab 3,6,15–18 . Many of them had family histories or previous symptoms of IBD further supporting the role of genetic polymorphism 3,6,17,18 …”

Section: Discussionmentioning

confidence: 99%

“…13,14 In addition to the clinical trial on secukinumab multiple case reports have emerged reporting patients who developed IBD while on secukinumab. 3,6,[15][16][17][18] Many of them had family histories F I G U R E 1 Colonoscopy photos from baseline colonoscopy with diverticulosis in descending and sigmoid colon, otherwise normal. Sigmoidoscopy photos after patient treated with secukinumab (postsecukinumab) showing ulcerated and edematous mucosa in sigmoid colon.…”

Section: Discussionmentioning

confidence: 99%

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New onset inflammatory bowel disease in patient treated with secukinumab: Case report and review of literature

Ali

Torosian

Porter

et al. 2021

Dermatologic Therapy

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Psoriasis is a chronic autoimmune skin disorder that can vary in severity and extent of disease. While localized disease can be managed with topical medications, widespread disease often requires systemic therapy including biologics. This medication class targets different components of the immune system and thus modulates disease activity. The biologic secukinumab is a human monoclonal antibody against

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“…The association between IL-17 inhibitors and the potential risk of IBD exacerbation was also documented in several case reports. Haidari et al reported a case of asymptomatic CD in patients with psoriasis following secukinumab treatment [114]. Johnston and Veettil presented a case of a patient with psoriasis who developed UC during treatment initiation with secukinumab [115].…”

Section: Il-17 Inhibitorsmentioning

confidence: 99%

Biologic and Small-Molecule Therapies for Moderate-to-Severe Psoriasis: Focus on Psoriasis Comorbidities

Jiang

Chen

et al. 2023

BioDrugs

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Psoriasis is a systemic immune-mediated disease associated with an increased risk of comorbidities, such as psoriatic arthritis, cardiovascular disease, metabolic syndrome, inflammatory bowel disease, psychiatric disorders, and malignancy. In recent years, with the advent of biological agents, the efficacy and safety of psoriasis treatments have dramatically improved. Presently, tumor necrosis factor-α inhibitors, interleukin-17 inhibitors, interleukin-12/23 inhibitors, and interleukin-23 inhibitors are approved to treat moderate-to-severe psoriasis. Small-molecule inhibitors, such as apremilast and deucravacitinib, are also approved for the treatment of psoriasis. Although it is still unclear, systemic agents used to treat psoriasis also have a significant impact on its comorbidities by altering the systemic inflammatory state. Data from clinical trials and studies on the safety and efficacy of biologics and small-molecule inhibitors provide important information for the personalized care and treatment for patients with psoriasis. Notably, treatment with interleukin-17 inhibitors is associated with new-onset or exacerbations of inflammatory bowel disease. In addition, great caution needs to be taken when using tumor necrosis factor-α inhibitors in patients with psoriasis with concomitant congestive heart failure, multiple sclerosis, and malignancy. Apremilast may induce weight loss as an adverse effect, presenting also with some beneficial metabolic actions. A better understanding of the characteristics of biologics and small-molecule inhibitors in the treatment of psoriasis comorbidities can provide more definitive guidance for patients with distinct comorbidities.

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Asymptomatic Crohn’s disease identified in a patient being treated with secukinumab: A case report

Cited by 8 publications

References 13 publications

IL-17 inhibitor-associated inflammatory bowel disease: A study based on literature and database analysis

IL-17 inhibitor-associated inflammatory bowel disease: A study based on literature and database analysis

New onset inflammatory bowel disease in patient treated with secukinumab: Case report and review of literature

Biologic and Small-Molecule Therapies for Moderate-to-Severe Psoriasis: Focus on Psoriasis Comorbidities

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