Multifaceted Secukinumab-induced Colitis

Sykaras, Alexandros G.; Margellou, Evangelia; Panagopoulos, Fotis; Geladari, Eleni; Alevizakis, Ioannis

doi:10.1093/ibd/izab267

Cited by 2 publications

(2 citation 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%

“…Interleukin (IL)-17 is a significant proinflammatory cytokine and a therapeutic target for rheumatological diseases as blocking IL-17 reduces disease activity and improves patient quality of life (Ouyang et al, 2008). The anti-IL-17 agents secukinumab (SEC), ixekizumab (IXE), and brodalumab (BRO), which were launched in January 2015, April 2016, and July 2017, respectively, are monoclonal IgG4 antibodies directed against IL-17A (SEC and IXE), or against the IL-17 receptor (BRO) (Langley et al, 2014;Griffiths et al, 2015;Lebwohl et al, 2015), and have been used to treat various autoimmune disorders, such as psoriasis (Pso), psoriatic arthritis (PsA), ankylosing spondylitis (AS), and axial spondyloarthritis (ax-Spa) (van der Heijde et al, 2017;Menter et al, 2019;Gossec et al, 2020;Wendling et al, 2022;Ramiro et al, 2023). Promising efficacy results in dermatology and rheumatology prompted the evaluation of these drugs in treatment of inflammatory bowel disease (IBD).…”

Section: Introductionmentioning

confidence: 99%

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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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