Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, North Carolina, USA.
Section of Gastroenterology, Wake Forest School of Medicine, North Carolina, USA.
Dermatol Ther. 2021 Nov;34(6):e15151. doi: 10.1111/dth.15151. Epub 2021 Oct 13.
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 interleukin-17A used for the treatment of psoriasis and psoriatic arthritis; cases of inflammatory bowel disease (IBD) have been observed in clinical trials to be associated with this medication. This review aims to provide evidence for the relationships between secukinumab treatment and the development of IBD. We have examined review articles and original research papers, published between 2010 and 2020, using the following keywords: psoriasis, psoriatic arthritis, secukinumab, IBD, Crohn's disease, ulcerative colitis, interleukin-17, IL-17, IL-17 inhibitor. Case reports have noted an association between secukinumab use and IBD and have called for IBD pre-screening in patients who will be prescribed this medication. Clinical trials concluded that secukinumab was associated with IBD, while retrospective studies have had mixed results, with most studies showing no statistical significance between secukinumab and IBD but having seen patients with history of IBD or family histories experience new-onset IBD or flare-ups. Given the utilization of secukinumab as a therapy for psoriasis and psoriatic arthritis, appropriate screening and risk stratification could help limit morbidity and mortality that can be associated with secukinumab-induced IBD.
银屑病是一种慢性自身免疫性皮肤病,其严重程度和疾病范围各不相同。虽然局部疾病可以通过局部药物治疗,但广泛的疾病通常需要系统治疗,包括生物制剂。这类药物靶向免疫系统的不同成分,从而调节疾病活动。生物制剂司库奇尤单抗是一种针对白细胞介素-17A 的人单克隆抗体,用于治疗银屑病和银屑病关节炎;临床试验中观察到炎症性肠病 (IBD) 与这种药物有关。本综述旨在为司库奇尤单抗治疗与 IBD 发展之间的关系提供证据。我们使用以下关键词检查了 2010 年至 2020 年期间发表的综述文章和原始研究论文:银屑病、银屑病关节炎、司库奇尤单抗、IBD、克罗恩病、溃疡性结肠炎、白细胞介素-17、IL-17、IL-17 抑制剂。病例报告指出司库奇尤单抗使用与 IBD 之间存在关联,并呼吁在开这种药物之前对患者进行 IBD 预筛查。临床试验得出结论,司库奇尤单抗与 IBD 有关,而回顾性研究结果喜忧参半,大多数研究表明司库奇尤单抗与 IBD 之间无统计学意义,但有 IBD 病史或家族病史的患者出现新发病例或 IBD 发作。鉴于司库奇尤单抗作为银屑病和银屑病关节炎的治疗药物,适当的筛查和风险分层有助于降低与司库奇尤单抗诱导的 IBD 相关的发病率和死亡率。