Darch K M, Holland T L, Spelman L J
Veracity Clinical Research, Woolloongabba, QLD 4102, Australia.
Case Rep Med. 2020 Jul 24;2020:9404505. doi: 10.1155/2020/9404505. eCollection 2020.
Chronic plaque psoriasis and psoriatic arthritis are common autoimmune inflammatory conditions, often existing as comorbidities that have a significant impact on a patient's quality of life. The availability of a range of novel, targeted therapies for their treatment, most notably the availability of biologic agents, has revolutionised management of these conditions and allowed for significant improvements in patient outcomes. Secukinumab (Cosentyx), a fully-human monoclonal antibody that acts by selectively binding to and neutralising the proinflammatory cytokine IL-17A, is used widely for the treatment of both chronic plaque psoriasis and psoriatic arthritis. In this report, we discuss the case of a 54-year-old female with chronic plaque psoriasis and psoriatic arthritis, who experienced the onset of symptoms and was subsequently diagnosed with Crohn's disease during treatment with secukinumab. It was determined by the gastroenterologist that this may represent secukinumab-induced inflammatory bowel disease. We will review the current understanding of the role of IL-17 in inflammatory bowel disease and the important role of novel agents that target the p19 subunit of IL-23 which have shown significant promise in the management of not only chronic plaque psoriasis and psoriatic arthritis, but also inflammatory bowel disease itself.
慢性斑块状银屑病和银屑病关节炎是常见的自身免疫性炎症性疾病，常合并存在，对患者的生活质量有重大影响。一系列用于治疗它们的新型靶向疗法的出现，尤其是生物制剂的问世，彻底改变了这些疾病的治疗方式，并使患者的治疗效果有了显著改善。司库奇尤单抗（可善挺）是一种全人源单克隆抗体，通过选择性结合并中和促炎细胞因子IL-17A发挥作用，被广泛用于治疗慢性斑块状银屑病和银屑病关节炎。在本报告中，我们讨论了一名54岁患有慢性斑块状银屑病和银屑病关节炎的女性病例，该患者在接受司库奇尤单抗治疗期间出现症状并随后被诊断为克罗恩病。胃肠病学家确定这可能是司库奇尤单抗诱发的炎症性肠病。我们将回顾目前对IL-17在炎症性肠病中的作用的认识，以及靶向IL-23 p19亚基的新型药物的重要作用，这些药物不仅在慢性斑块状银屑病和银屑病关节炎的治疗中显示出巨大潜力，而且在炎症性肠病本身的治疗中也有显著效果。
