Fieldhouse Keira A, Ukaibe Samantha, Crowley Erika L, Khanna Reena, O'Toole Ashley, Gooderham Melinda J
SKiN Centre for Dermatology, 775 Monaghan Road South, Peterborough, ON K9J 5K2, Canada.
Trent University, 1600 W Bank Dr, Peterborough, ON K9J 0G2, Canada.
Drugs Context. 2020 Apr 21;9. doi: 10.7573/dic.2020-2-1. eCollection 2020.
Interleukin 17 (IL-17) inhibitors provide an excellent treatment option for patients with psoriasis and psoriatic arthritis, resulting in high levels of efficacy for skin clearance and joint improvement. Safety has also been established in clinical trials for this group of biologic agents; however, rare case reports of exacerbation or induction of inflammatory bowel disease (IBD) have been reported in the literature. No causal relationship has been established. When IL-17 inhibitors were investigated for the management of IBD, no benefit was found and worsening of disease was noted for some patients. IBD is more common in patients with psoriasis and, therefore, it remains unknown if these drugs cause de novo IBD or if the reported cases of IBD in patients on IL-17 therapy is due to the background risk in this predisposed population who may have already had an underlying or subclinical disease.
METHODS/RESULTS: A literature search was conducted for the terms 'IL-17 inhibitor,' 'ixekizumab,' 'secukinumab,' 'brodalumab' and 'inflammatory bowel disease,' 'ulcerative colitis,' and 'Crohn's disease' in PubMed and Google Scholar. Cases of new-onset or exacerbation of IBD were identified in the literature along with postmarketing pharmacovigilance data. These cases will be reviewed in this paper.
IL-17 inhibitors have proven efficacy for the treatment of psoriasis and psoriatic arthritis with a strong safety profile. However, rare cases of IBD onset and exacerbation in patients on IL-17 inhibitors have been reported in the literature, highlighting the need to select patients and therapeutic choices appropriately when treating this population.
白细胞介素17（IL-17）抑制剂为银屑病和银屑病关节炎患者提供了一种出色的治疗选择，在清除皮肤病变和改善关节症状方面疗效显著。这类生物制剂在临床试验中也已证实了安全性；然而，文献中已有罕见的炎症性肠病（IBD）病情加重或诱发的病例报告。尚未确立因果关系。在对IL-17抑制剂治疗IBD进行研究时，未发现有益效果，且部分患者病情出现恶化。IBD在银屑病患者中更为常见，因此，这些药物是否会引发新发IBD，或者接受IL-17治疗的患者中报告的IBD病例是否归因于该易感人群中可能已存在的潜在或亚临床疾病的背景风险，目前仍不清楚。
方法/结果：在PubMed和谷歌学术中检索了“IL-17抑制剂”“司库奇尤单抗”“苏金单抗”“布罗达单抗”以及“炎症性肠病”“溃疡性结肠炎”和“克罗恩病”等关键词。从文献以及上市后药物警戒数据中识别出IBD新发或病情加重的病例。本文将对这些病例进行综述。
IL-17抑制剂已被证明在治疗银屑病和银屑病关节炎方面疗效显著且安全性良好。然而，文献中已有关于接受IL-17抑制剂治疗的患者出现IBD发病和病情加重的罕见病例报告，这凸显了在治疗该人群时合理选择患者和治疗方案的必要性。
