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

Ali, Ailia K.; Torosian, Arman; Porter, Caroline L; Bloomfeld, Richard S.; Feldman, Steven R.

doi:10.1111/dth.15151

Cited by 8 publications

(6 citation statements)

References 20 publications

(102 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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“…Recent studies on the pathogenesis of HS have shown that the patients with HS have imbalances in the T helper 17/interleukin (IL)‐17 axis 10–12 . However, they may exacerbate inflammatory bowel disease or induce a new‐onset condition 13,14 . One patient in our cohort had Crohn's disease, and thus, anti‐IL‐17 agents could not be considered.…”

Section: Discussionmentioning

confidence: 99%

“…[10][11][12] However, they may exacerbate inflammatory bowel disease or induce a new-onset condition. 13,14 One patient in our cohort had Crohn's disease, and thus, anti-IL-17 agents could not be considered. However, three patients had previously used secukinumab, and two of three reported worsening.…”

Section: Discussionmentioning

confidence: 99%

Certolizumab pegol in the treatment of severe hidradenitis suppurativa after adalimumab failure: A real‐life experience

Eşme

Akoğlu

Dalkıran

et al. 2022

Dermatologic Therapy

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There exists an unmet need to treat hidradenitis suppurativa (HS) despite several approved therapeutic agents for its treatment. We sought to investigate the role of certolizumab pegol in severe, recalcitrant HS patients unresponsive to adalimumab. This retrospective cohort includes HS patients over 18 years of age who had a history of unresponsiveness to adalimumab and whose treatments were switched to certolizumab pegol with dosing similar to psoriasis (400 mg every 2 weeks). For subjects who achieved a hidradenitis suppurativa clinical response (HiSCR) following 12 and 24 weeks of treatment, dermatological life quality index (DLQI), abscess, inflammatory nodule count (AN count), and International Hidradenitis Suppurativa Severity Score System (IHS4) were evaluated as outcome measures. Eleven severe, recalcitrant HS patients with Hurley stage III HS were enrolled for this study. All patients were male and had a history of prior adalimumab exposure. Only three (27.2%) patients also had a history of using biologic agents other than adalimumab for HS. Six of 11 patients (54.5%) achieved HiSCR at week 12. However, two among these six responders lost response at week 24 despite continued therapy (HiSCR at week 24: 33.3%). The decrease in DLQI (p: 0.017 and 0.021) and IHS4 (p: 0.008 and 0.007) scores of the patients at weeks 12 and 24 showed a significant difference compared to the baseline. Certolizumab pegol is a promising treatment option for severe, recalcitrant HS patients who are unresponsive to adalimumab.

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“…A comparative study indicated that patients with PsA/AS, initiating IL-17A-inhibitor therapy do not have a higher risk of developing IBD when compared to patients initiating etanercept [ 24 ]. However, similar cases of new-onset colitis during IL-17A-inhibitor therapy [ 9 , 10 , 12 , 13 , 15 ] and data suggesting paradoxical colitis activity in Crohn’s disease patients [ 8 ] raise concerns. Given the typical overall presentation of the case as well as the new onset of symptoms after recent exposure to secukinumab, a drug-induced etiology of IBD seemed plausible.…”

Section: Discussionmentioning

confidence: 99%

Colitis induced by IL-17A-inhibitors

Grümme,

Dombret,

Knösel

et al. 2023

Clin J Gastroenterol

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Background Interleukin (IL)-17A is essential for intestinal mucosal integrity, contributing to the prevention of detrimental immunity such as infectious colitis and inflammatory bowel disease (IBD). Indeed, neutralization of IL-17A has been abandoned as a therapeutic principle in IBD because of increased disease activity. However, it is controversial whether IL-17A inhibitors increase the risk of developing colitis in patients who do not have underlying IBD. Here, we present two cases of different forms of colitis that occurred during treatment with two IL-17A inhibitors, secukinumab and ixekizumab. Case presentations We report the case of a 35-year-old female with SAPHO (synovitis–acne–pustulosis–hyperostosis–osteitis) syndrome who was admitted due to severe colitis with bloody diarrhea, fever, abdominal pain and weight loss after receiving secukinumab for 3 months as well as the case of a 41-year-old male with psoriatic arthritis who presented himself to the outpatient clinic with bloody stools, abdominal pain and nausea 5 months after changing his therapy from secukinumab to ixekizumab. In both patients, treatment with IL-17A-inhibitors was stopped and tumor necrosis factor inhibitors were started. Both patients recovered, are clinically stable and show no more signs of active colitis. Conclusion The role of IL-17A inhibitors in the pathogenesis of infectious colitis and new-onset IBD is not fully understood and requires further research. Patients receiving IL-17A-inhibitor therapy should be carefully screened and notified of the possible side effects.

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

Cited by 8 publications

References 20 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

Certolizumab pegol in the treatment of severe hidradenitis suppurativa after adalimumab failure: A real‐life experience

Colitis induced by IL-17A-inhibitors

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